Block Valerie J, Bove Riley, Nourbakhsh Bardia
Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.
Department of Neurology, Johns Hopkins University, Baltimore, MD, United States.
Front Neurol. 2022 Jun 27;13:878313. doi: 10.3389/fneur.2022.878313. eCollection 2022.
Fatigue is one of the most common multiple sclerosis (MS) symptoms. Despite this, monitoring and measuring fatigue (subjective lack of energy)- and fatigability (objectively measurable and quantifiable performance decline)- in people with MS have remained challenging. Traditionally, administration of self-report questionnaires during in-person visits has been used to measure fatigue. However, remote measurement and monitoring of fatigue and fatigability have become feasible in the past decade. Traditional questionnaires can be administered through the web in any setting. The ubiquitous availability of smartphones allows for momentary and frequent measurement of MS fatigue in the ecological home-setting. This approach reduces the recall bias inherent in many traditional questionnaires and demonstrates the fluctuation of fatigue that cannot be captured by standard measures. Wearable devices can assess patients' fatigability and activity levels, often influenced by the severity of subjective fatigue. Remote monitoring of fatigue, fatigability, and activity in real-world situations can facilitate quantifying symptom-severity in clinical and research settings. Combining remote measures of fatigue as well as objective fatigability in a single construct, composite score, may provide a more comprehensive outcome. The more granular data obtained through remote monitoring techniques may also help with the development of interventions aimed at improving fatigue and lowering the burden of this disabling symptom.
疲劳是多发性硬化症（MS）最常见的症状之一。尽管如此，监测和测量MS患者的疲劳（主观上缺乏精力）和易疲劳性（客观上可测量和量化的性能下降）仍然具有挑战性。传统上，在面对面就诊期间使用自我报告问卷来测量疲劳。然而，在过去十年中，对疲劳和易疲劳性进行远程测量和监测已变得可行。传统问卷可以在任何环境下通过网络进行管理。智能手机的广泛普及使得能够在自然的家庭环境中对MS疲劳进行即时和频繁的测量。这种方法减少了许多传统问卷中固有的回忆偏差，并展示了标准测量方法无法捕捉到的疲劳波动。可穿戴设备可以评估患者的易疲劳性和活动水平，这通常受主观疲劳严重程度的影响。在现实世界中对疲劳、易疲劳性和活动进行远程监测有助于在临床和研究环境中量化症状严重程度。将疲劳的远程测量以及客观易疲劳性整合到一个单一的结构、综合评分中，可能会提供一个更全面的结果。通过远程监测技术获得的更详细的数据也可能有助于开发旨在改善疲劳和减轻这种致残症状负担的干预措施。
