Rudroff Thorsten, Kindred John H, Ketelhut Nathaniel B
Department of Health and Exercise Science, Colorado State University , Fort Collins, CO , USA.
Front Neurol. 2016 Aug 2;7:122. doi: 10.3389/fneur.2016.00122. eCollection 2016.
Fatigue is one of the most disabling side effects in people with multiple sclerosis. While this fact is well known, there has been a remarkable lack of progress in determining the pathophysiological mechanisms behind fatigue and the establishment of effective treatments. The main barrier has been the lack of a unified definition of fatigue that can be objectively tested with validated experimental models. In this "perspective article" we propose the use of the following model and definition of fatigue: the decrease in physical and/or mental performance that results from changes in central, psychological, and/or peripheral factors. These changes depend on the task being performed, the environmental conditions it is performed in, and the physical and mental capacity of the individual. Our definition and model of fatigue outlines specific causes of fatigue and how it affects task performance. We also outline the strengths and weaknesses of commonly used measures of fatigue and suggest, based on our model and definition, new research strategies, which should include multiple measures. These studies should be mechanistic with validated experimental models to determine changes in central, psychological, and/or peripheral factors that explain fatigue. The proposed new research strategies may lead to the identification of the origins of MS related fatigue and the development of new, more effective treatments.
疲劳是多发性硬化症患者最具致残性的副作用之一。尽管这一事实广为人知，但在确定疲劳背后的病理生理机制以及建立有效治疗方法方面，进展却极为有限。主要障碍在于缺乏一个能够通过经过验证的实验模型进行客观测试的统一疲劳定义。在这篇“观点文章”中，我们提出使用以下疲劳模型和定义：由中枢、心理和/或外周因素的变化导致的身体和/或精神表现的下降。这些变化取决于所执行的任务、执行任务的环境条件以及个体的身心能力。我们的疲劳定义和模型概述了疲劳的具体成因以及它如何影响任务表现。我们还概述了常用疲劳测量方法的优缺点，并基于我们的模型和定义提出了新的研究策略，其中应包括多种测量方法。这些研究应采用经过验证的实验模型进行机制研究，以确定解释疲劳的中枢、心理和/或外周因素的变化。所提出的新研究策略可能会导致识别与多发性硬化症相关的疲劳的根源，并开发出新的、更有效的治疗方法。
