Koch M, Uyttenboogaart M, van Harten A, Heerings M, De Keyser J
Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Mult Scler. 2008 Jul;14(6):815-22. doi: 10.1177/1352458508088937. Epub 2008 Jun 5.
To investigate the effect of fatigue and depression on disease progression in multiple sclerosis (MS), and the long-term prognosis of these symptoms.
228 patients with MS were investigated for fatigue and depression with the Fatigue Severity Scale (FSS) and Center for Epidemiologic Studies Depression Scale (CES-D). These patients regularly attended the MS clinic, where disability scores and the development of secondary progression were monitored. After 10 years, the 149 patients remaining from the original cohort were asked to participate in a repeat assessment of fatigue and depression and 96 (64%) could be re-evaluated. In relapsing-remitting patients, the influence of baseline fatigue and depression on the risk of secondary progression during the following 10 years was assessed with survival analyses. In the whole patient group, we investigated the influence of baseline fatigue and depression on progression of disability at 10 years. We also investigated differences in fatigue, depression and disability scores between baseline and 10 years.
Fatigue and depression at baseline did not predict the development of secondary progression or progression of disability. Most patients who were fatigued or depressed at baseline remained so at 10 years, and the majority of patients not experiencing these symptoms remained free of them. FSS and CES-D scores were not significantly different between baseline and 10 years, while disability scores significantly increased.
Our data suggest that fatigue and depression in MS are unrelated to disease progression in MS. Fatigue and depression tend to persist at roughly the same levels over time.
探讨疲劳和抑郁对多发性硬化症（MS）疾病进展的影响，以及这些症状的长期预后。
采用疲劳严重程度量表（FSS）和流行病学研究中心抑郁量表（CES-D）对228例MS患者的疲劳和抑郁情况进行调查。这些患者定期前往MS门诊，在那里监测残疾评分和继发进展情况。10年后，邀请原始队列中剩余的149例患者参与疲劳和抑郁的重复评估，其中96例（64%）可进行重新评估。在复发缓解型患者中，采用生存分析评估基线疲劳和抑郁对接下来10年继发进展风险的影响。在整个患者组中，我们研究了基线疲劳和抑郁对10年时残疾进展的影响。我们还研究了基线和10年时疲劳、抑郁及残疾评分的差异。
基线时的疲劳和抑郁不能预测继发进展或残疾进展。大多数基线时疲劳或抑郁的患者在10年后仍如此，而大多数未出现这些症状的患者仍未出现。FSS和CES-D评分在基线和10年之间无显著差异，而残疾评分显著增加。
我们的数据表明，MS中的疲劳和抑郁与MS的疾病进展无关。随着时间的推移，疲劳和抑郁倾向于维持在大致相同的水平。
