Department of Neurology, University of Florence, Florence, Italy.
Mult Scler. 2012 Mar;18(3):329-34. doi: 10.1177/1352458511420846. Epub 2011 Aug 15.
There is limited information on fatigue and its clinical and psychosocial correlates in children and adolescents with multiple sclerosis (MS).
To assess the relationships between fatigue, cognitive functioning and depression in paediatric MS.
The study cohort consisted of patients with MS recruited for an Italian collaborative study on cognitive and psychosocial functioning in paediatric MS. The present assessment included evaluation of fatigue on the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale, cognitive functioning on an extensive neuropsychological battery and depression on the Children's Depression Inventory (CDI). A psychiatric interview through the Kiddie-SADS-Present and Lifetime Version was also administered.
In total, 57 patients with relapsing-remitting MS were compared with 70 healthy controls. Percentages of fatigued patients ranged from 9% to 14% according to self-reports, and from 23% to 39% according to parent reports. Fatigue was significantly related with higher scores on the CDI (p < 0.03). Higher levels of self-reported cognitive fatigue were associated with impaired performance on a problem-solving test, whereas higher levels of parent-reported cognitive fatigue were associated with impairment on tests of verbal learning, processing speed, complex attention and verbal comprehension.
Our data show that fatigue can affect a sizeable proportion of paediatric MS patients, and confirm the association between fatigue and depressive symptoms in MS. They also highlight the difficulties of fatigue assessment in the paediatric population and provide a few clues to further research in the field.
关于多发性硬化症（MS）患儿的疲劳及其临床和心理社会相关性的信息有限。
评估儿科 MS 患者的疲劳、认知功能和抑郁之间的关系。
研究队列由意大利合作研究中招募的多发性硬化症患儿组成，该研究旨在评估儿科 MS 的认知和心理社会功能。目前的评估包括使用儿童生活质量问卷多维疲劳量表评估疲劳、使用广泛的神经心理学测试评估认知功能以及使用儿童抑郁量表（CDI）评估抑郁。还通过 Kiddie-SADS-Present 和 Lifetime 版本进行了精神病学访谈。
总共比较了 57 名缓解-复发型 MS 患者和 70 名健康对照者。根据自我报告，疲劳患者的比例从 9%到 14%不等，根据父母报告，疲劳患者的比例从 23%到 39%不等。疲劳与 CDI 得分较高显著相关（p<0.03）。自我报告的认知疲劳程度较高与解决问题测试的表现受损有关，而父母报告的认知疲劳程度较高与言语学习、处理速度、复杂注意力和言语理解测试的受损有关。
我们的数据表明，疲劳会影响相当一部分儿科 MS 患者，并且证实了 MS 中疲劳与抑郁症状之间的关联。它们还突出了儿科人群中疲劳评估的困难，并为该领域的进一步研究提供了一些线索。
