Patrick E, Christodoulou C, Krupp L B
Department of Neurology, State University of New York at Stony Brook, New York 11794-8121, USA.
Mult Scler. 2009 Feb;15(2):258-61. doi: 10.1177/1352458508097466.
To determine the predictors of longitudinal changes in fatigue based on pain, mood, and neurological impairment across multiple sclerosis (MS) subtypes.
Fatigue is the most common symptom of MS but remains poorly understood. The New York State Multiple Sclerosis Consortium (NYSMSC) database offers a unique opportunity to longitudinally assess a variety of potential fatigue correlates in a very large and diverse MS sample.
DESIGN/METHODS: This study examined baseline and 1-year follow-up data on 2768 patients drawn from the NYSMSC database regarding fatigability, pain, depressive symptoms, MS subtype, and expanded disability status scale (EDSS). Correlates and predictors of fatigue were assessed in correlational and multiple regression analyses.
Baseline fatigue, pain, and depression accounted for 34.6% of the variance in 1-year follow-up fatigue scores. Fatigue was lower in relapsing-remitting subjects than in other MS subtypes. Fatigue consistently correlated at baseline and follow-up with depressive symptoms, pain severity, and EDSS. Changes in fatigue correlated with changes in other variables.
Predictors of fatigue at 1 year include baseline fatigue, pain, mood, and EDSS. These symptoms are also correlated at baseline, follow-up, and in change scores. Identifying predictors of fatigue may facilitate patient management.
基于多发性硬化症（MS）各亚型的疼痛、情绪和神经功能障碍，确定疲劳纵向变化的预测因素。
疲劳是MS最常见的症状，但仍未被充分了解。纽约州多发性硬化症联盟（NYSMSC）数据库提供了一个独特的机会，可在一个非常大且多样化的MS样本中纵向评估各种潜在的疲劳相关因素。
设计/方法：本研究检查了从NYSMSC数据库中抽取的2768例患者的基线数据和1年随访数据，内容包括疲劳易感性、疼痛、抑郁症状、MS亚型和扩展残疾状态量表（EDSS）。在相关性分析和多元回归分析中评估疲劳的相关因素和预测因素。
基线时的疲劳、疼痛和抑郁占1年随访疲劳评分方差的34.6%。复发缓解型患者的疲劳程度低于其他MS亚型。在基线和随访时，疲劳与抑郁症状、疼痛严重程度和EDSS始终相关。疲劳的变化与其他变量的变化相关。
1年时疲劳的预测因素包括基线时的疲劳、疼痛、情绪和EDSS。这些症状在基线、随访和变化评分中也具有相关性。识别疲劳的预测因素可能有助于患者管理。
