Yang Jin-Shan, Xu Hao-Ling, Chen Ping-Ping, Sikandar Arif, Qian Mei-Zhen, Lin Hui-Xia, Lin Min-Ting, Chen Wan-Jin, Wang Ning, Wu Hua, Gan Shi-Rui
Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Front Neurol. 2020 Apr 22;11:266. doi: 10.3389/fneur.2020.00266. eCollection 2020.
Spinocerebellar ataxia type 3 (SCA3) is an inherited form of ataxia that leads to progressive neurodegeneration. Fatigue is a common non-motor symptom in SCA3 and other neurodegenerative diseases, such as Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS). Although risk factors to fatigue in these diseases have been thoroughly studied, whether or not fatigue can affect clinical phenotypes has yet to be investigated. Ninety-one molecularly confirmed SCA3 patients and 85 age- and sex-matched controls were recruited for this study. The level of fatigue was measured using the 14-item Fatigue Scale (FS-14), and the risk factors to fatigue and how fatigue correlates with clinical phenotypes were studied using multivariable linear regression models. We found that the severity was significantly higher in the SCA3 group than in the control group (9.30 ± 3.04% vs. 3.94 ± 2.66, = 0.000). Daytime somnolence (β = 0.209, = 0.002), severity of ataxia (β = 0.081, = 0.006), and poor sleep quality (β = 0.187, = 0.037) were found to have a positive relationship with fatigue. Although fatigue had no relationship with age at onset or ataxic progression, we found that it did have a positive relationship with the severity of ataxia (β = 7.009, = 0.014). The high level of fatigue and the impact of fatigue on the clinical manifestation of SCA3 patients suggest that fatigue plays a large role in the pathogenesis of SCA3, thus demonstrating the need for intervention and treatment options in this patient cohort.
3型脊髓小脑共济失调(SCA3)是一种遗传性共济失调,可导致进行性神经退行性变。疲劳是SCA3以及其他神经退行性疾病(如帕金森病(PD)和肌萎缩侧索硬化症(ALS))中常见的非运动症状。尽管已经对这些疾病中疲劳的危险因素进行了深入研究,但疲劳是否会影响临床表型尚未得到研究。本研究招募了91例经分子确诊的SCA3患者和85例年龄及性别匹配的对照。使用14项疲劳量表(FS - 14)测量疲劳程度,并使用多变量线性回归模型研究疲劳的危险因素以及疲劳与临床表型的相关性。我们发现,SCA3组的严重程度显著高于对照组(9.30±3.04%对3.94±2.66,P = 0.000)。发现日间嗜睡(β = 0.209,P = 0.002)、共济失调严重程度(β = 0.081,P = 0.006)和睡眠质量差(β = 0.187,P = 0.037)与疲劳呈正相关。虽然疲劳与发病年龄或共济失调进展无关,但我们发现它与共济失调严重程度呈正相关(β = 7.009,P = 0.014)。SCA3患者的高疲劳水平及其对临床表现的影响表明,疲劳在SCA3的发病机制中起很大作用,因此表明在该患者群体中需要干预和治疗方案。