Téllez N, Río J, Tintoré M, Nos C, Galán I, Montalban X
2a planta EUI Unitat de Neuroimmunología, Clínica Hospital, Universitari Vall d'Hebron Ps, Vall d'Hebron 119-120, 08035, Barcelona, Spain.
J Neurol. 2006 Nov;253(11):1466-70. doi: 10.1007/s00415-006-0247-3. Epub 2006 Jun 13.
Fatigue is one of the most frequent symptoms in multiple sclerosis (MS) but there is a lack of knowledge about its behaviour over time. The aim of our study was to investigate changes in fatigue in a large cohort of MS patients and to determine the relationship between changes in disability and depression with changes in fatigue severity.
We studied fatigue in 227 MS consecutive patients and again after one year. During the clinical interview, we recorded the patient's degree of disability using the Expanded Disability Status Scale and relapses; fatigue was measured by means of the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) and depression was measured by the Beck Depression Inventory (BDI).
After a mean follow-up of 18 months, 86.8% of patients who were fatigued at study onset remained in a fatigued status, whereas 25% of those without fatigue at onset had become fatigued at the end of follow-up. We observed that only variations on BDI scores positively correlate with variations on fatigue scales, mainly with MFIS (r = 0.49, p < 0.0001). An increase of BDI score was the factor that best predicted the increase of fatigue over time. No differences in the increase of fatigue were found between patients with and without progression of disability during the follow-up period, or between patients with or without relapses.
Fatigue in MS persists over time. Changes in mood status but not in disability are related to changes in fatigue in MS patients.
疲劳是多发性硬化症（MS）最常见的症状之一，但对其随时间变化的情况了解不足。我们研究的目的是调查一大群MS患者疲劳情况的变化，并确定残疾和抑郁的变化与疲劳严重程度变化之间的关系。
我们对227例连续的MS患者进行了疲劳情况研究，并在一年后再次进行研究。在临床访谈期间，我们使用扩展残疾状态量表记录患者的残疾程度和复发情况；通过改良疲劳影响量表（MFIS）和疲劳严重程度量表（FSS）测量疲劳程度，通过贝克抑郁量表（BDI）测量抑郁程度。
平均随访18个月后，研究开始时感到疲劳的患者中有86.8%仍处于疲劳状态，而开始时无疲劳的患者中有25%在随访结束时变得疲劳。我们观察到，只有BDI评分的变化与疲劳量表的变化呈正相关，主要是与MFIS（r = 0.49，p < 0.0001）。BDI评分的增加是最能预测疲劳随时间增加的因素。在随访期间，残疾有进展和无进展的患者之间，以及有复发和无复发的患者之间，疲劳增加情况没有差异。
MS患者的疲劳会随时间持续存在。MS患者疲劳情况的变化与情绪状态的变化有关，而与残疾情况的变化无关。
