Téllez N, Montalbán X
Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona.
Neurologia. 2004 Oct;19(8):434-7.
Fatigue is one of the most frequent and disabling symptoms in multiple sclerosis (MS) patients. This symptom's etiopathogenic mechanism, though not known, seems complex and multifactorial, and its therapeutic management is difficult. Different treatments have been tested in recent years, but a weak efficacy that may be limited in time has been observed. Recently, modafinil has been suggested as a possible treatment for fatigue in MS patients, although nowadays, the only use of modafinil approved by the Food and Drug Administration is narcolepsy. Modafinil, 2-([difenilmetil]sulfinil), acetamide is a state of wakeness promoter, and although its exact action mechanism is not known, it differs from other central nervous system stimulants because no dopaminergic activation is observed, and its action take place at the hypothalamic level. It is known that modafinil increases the proportion of high-frequency alpha waves and reduces delta and theta waves, increasing vigilance. Although few studies exist on modafinil in MS patients with fatigue, the results suggest this drug as a promising treatment, because of its efficacy and safety, and should encourage us to continue working in this area.
疲劳是多发性硬化症（MS）患者最常见且致残的症状之一。尽管这种症状的发病机制尚不清楚，但似乎复杂且具有多因素性，其治疗管理也很困难。近年来已经对不同的治疗方法进行了测试，但观察到疗效较弱且可能在时间上有限。最近，莫达非尼被认为可能是治疗MS患者疲劳的一种方法，尽管目前美国食品药品监督管理局批准的莫达非尼的唯一用途是治疗发作性睡病。莫达非尼，2 -（[二苯基甲基]亚磺酰基）乙酰胺，是一种促觉醒药物，尽管其确切作用机制尚不清楚，但它与其他中枢神经系统兴奋剂不同，因为未观察到多巴胺能激活，其作用发生在下丘脑水平。已知莫达非尼可增加高频α波的比例并减少δ波和θ波，从而提高警觉性。尽管关于莫达非尼治疗MS疲劳患者的研究很少，但结果表明这种药物因其疗效和安全性而有望成为一种治疗方法，应该鼓励我们继续在这一领域开展研究。
