Department of Neurology, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
Mult Scler. 2011 May;17(5):604-12. doi: 10.1177/1352458510392262. Epub 2010 Dec 6.
There has been considerable debate regarding the precise relationships between fatigue in multiple sclerosis (MS) and disease-related factors, such as disability, sleep disturbance, depression, age and sex. Existing studies give conflicting information.
To clarify such relationships in a large cross-sectional study, using a rigorously developed measurement tool which was based on a clear definition of fatigue.
A pack containing the Neurological Fatigue Index for MS Summary Scale, the Hospital Anxiety and Depression Scale, the Epworth Sleepiness Scale, the Multiple Sclerosis Impact Scale and questions regarding sleep and demographics was mailed to patients with MS attending two centres in the UK. All scale scores were converted to parametric measures using the Rasch measurement model. Both linear and non-linear relationships were sought.
Data from 635 respondents (52% response) were analysed. Fatigue was strongly related to the impact of MS. Fatigue was worse in those with progressive disease and clearly worsened once ambulation was affected. There was only weak correlation with anxiety and depression. Fatigue was not related to disease duration or patient age. There was an intimate but complex relation between fatigue and sleep. Fatigue levels were minimum at a nocturnal sleep duration of 7.5 h.
Clear relationships were found between fatigue and disability, disease type and sleep. Further physiological enquiry and trials of drug treatment and sleep modulation might be guided by these clinical relationships.
关于多发性硬化症（MS）中的疲劳与疾病相关因素（如残疾、睡眠障碍、抑郁、年龄和性别）之间的确切关系，存在着大量的争论。现有研究提供的信息相互矛盾。
在一项大型横断面研究中，使用经过严格开发的测量工具，基于对疲劳的明确定义，来阐明这些关系。
将包含多发性硬化症神经疲劳指数综合量表、医院焦虑抑郁量表、Epworth 嗜睡量表、多发性硬化症影响量表以及关于睡眠和人口统计学问题的问卷寄给在英国两个中心就诊的 MS 患者。使用 Rasch 测量模型将所有量表评分转换为参数测量。研究了线性和非线性关系。
对 635 名应答者（52%的应答率）的数据进行了分析。疲劳与 MS 的影响密切相关。进展性疾病患者的疲劳程度更严重，一旦活动能力受到影响，疲劳程度明显恶化。与焦虑和抑郁只有微弱的相关性。疲劳与疾病持续时间或患者年龄无关。疲劳与睡眠之间存在密切但复杂的关系。夜间睡眠时间为 7.5 小时时，疲劳水平最低。
在残疾、疾病类型和睡眠方面，疲劳与这些因素之间存在明确的关系。这些临床关系可能为进一步的生理学研究、药物治疗和睡眠调节试验提供指导。
