Capone Fioravante, Motolese Francesco, Falato Emma, Rossi Mariagrazia, Di Lazzaro Vincenzo
Unit of Neurology, Neurophysiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
NeXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Campus Bio-Medico University, Rome, Italy.
Front Neurol. 2020 Apr 22;11:251. doi: 10.3389/fneur.2020.00251. eCollection 2020.
Fatigue is a very common symptom among people with multiple sclerosis (MS), but its management in clinical practice is limited by the lack of clear evidence about the pathogenic mechanisms, objective tools for diagnosis, and effective pharmacological treatments. In this scenario, neurophysiology could play a decisive role, thanks to its ability to provide objective measures and to explore the peripheral and the central structures of the nervous system. We hereby review and discuss current evidence about the potential role of neurophysiology in the management of MS-related fatigue. In the first part, we describe the use of neurophysiological techniques for exploring the pathogenic mechanisms of fatigue. In the second part, we review the potential application of neurophysiology for monitoring the response to pharmacological therapies. Finally, we show data about the therapeutic implications of neurophysiological techniques based on non-invasive brain stimulation.
疲劳是多发性硬化症(MS)患者中非常常见的症状,但在临床实践中,由于缺乏关于致病机制的明确证据、客观的诊断工具和有效的药物治疗方法,其管理受到限制。在这种情况下,神经生理学因其能够提供客观测量并探索神经系统的外周和中枢结构,可能发挥决定性作用。我们在此回顾并讨论当前关于神经生理学在MS相关疲劳管理中潜在作用的证据。在第一部分,我们描述了使用神经生理学技术来探索疲劳的致病机制。在第二部分,我们回顾了神经生理学在监测药物治疗反应方面的潜在应用。最后,我们展示了基于非侵入性脑刺激的神经生理学技术的治疗意义的数据。