Shahrbanian Shahnaz, Duquette Pierre, Kuspinar Ayse, Mayo Nancy E
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada,
Qual Life Res. 2015 Mar;24(3):617-29. doi: 10.1007/s11136-014-0804-7. Epub 2014 Sep 17.
There were two objectives in this study: (1) to identify, among women and men with MS, the extent to which different MS-related symptoms, including fatigue, pain, sleep disturbance, depression, anxiety, irritability, cognitive impairment, spasticity, and poor balance, cluster and (2) to compare the contribution of generated symptom clusters to MS consequences including functional walking capacity, perceived health, illness intrusiveness, and quality of life (QOL).
This was a cross-sectional study. A center-stratified random sample comprising 139 women and 49 men was recruited from three major MS clinics in Montreal. Subjects completed several self-report and performance-based measures that assessed symptoms and downstream MS consequences. Hierarchical and K-means cluster analyses were used to create clusters.
Three symptom clusters were identified. Cluster 1, labeled the "emotional/cognitive symptom cluster," comprised of depression, anxiety, cognitive impairments, and irritability. The second cluster, labeled the "physical symptom cluster," included pain, fatigue, and sleep disorders. Cluster 3, labeled the "motor symptom cluster," included spasticity and poor balance. Furthermore, the motor symptom cluster had a strong effect on functional walking capacity, while it did not affect significantly illness intrusiveness and QOL. On the other hand, the physical symptom clusters and emotional/cognitive symptom clusters showed a significant contribution to prediction of illness intrusiveness and QOL. All symptom clusters showed a significant effect in predicting the overall variability of perceived health status.
The findings of this study provide useful information to help healthcare professionals, clinicians, and researchers to target symptoms that are often in the same cluster when one or two of them are present. Identification of the strength of the contributions of each symptom clusters to the targeted MS consequences would further help to prioritize treatment approaches for the MS population.
本研究有两个目标：（1）在患有多发性硬化症（MS）的女性和男性中，确定不同的MS相关症状，包括疲劳、疼痛、睡眠障碍、抑郁、焦虑、易怒、认知障碍、痉挛和平衡能力差，聚集的程度；（2）比较所生成的症状群对MS后果的影响，包括功能性步行能力、感知健康、疾病侵扰和生活质量（QOL）。
这是一项横断面研究。从蒙特利尔的三个主要MS诊所招募了一个中心分层随机样本，包括139名女性和49名男性。受试者完成了几项自我报告和基于表现的测量，以评估症状和MS的下游后果。使用层次聚类分析和K均值聚类分析来创建聚类。
确定了三个症状群。第1组标记为“情绪/认知症状群”，由抑郁、焦虑、认知障碍和易怒组成。第二组标记为“身体症状群”，包括疼痛、疲劳和睡眠障碍。第3组标记为“运动症状群”，包括痉挛和平衡能力差。此外，运动症状群对功能性步行能力有很强的影响，而对疾病侵扰和生活质量没有显著影响。另一方面，身体症状群和情绪/认知症状群对疾病侵扰和生活质量的预测有显著贡献。所有症状群在预测感知健康状况的总体变异性方面都有显著影响。
本研究的结果提供了有用的信息，以帮助医疗保健专业人员、临床医生和研究人员针对当出现一两个症状时通常在同一组中的症状。确定每个症状群对目标MS后果的贡献强度将进一步有助于为MS人群确定治疗方法的优先级。
