Barrios Liliana, Amon Rok, Oldrati Pietro, Hilty Marc, Holz Christian, Lutterotti Andreas
Department of Computer Science, ETH Zurich, Zurich, Switzerland.
University Hospital of Zurich, Zurich, Switzerland.
Digit Health. 2022 Aug 25;8:20552076221117740. doi: 10.1177/20552076221117740. eCollection 2022 Jan-Dec.
Fatigue is a common symptom of many diseases, including multiple sclerosis. It manifests as a cognitive or physical condition. Fatigue is poorly understood, and effective therapies are missing. Furthermore, there is a lack of methods to measure fatigue objectively. Fatigability, the measurable decline in performance during a task, has been suggested as a complementary method to quantify fatigue.
To develop a new and objective measurement of cognitive fatigability and investigate its association with perceived fatigue.
We introduced the cognitive fatigability assessment test (cFAST), a novel smartphone-based test to quantify cognitive fatigability. Forty-two people with multiple sclerosis (23 fatigued and 19 non-fatigued, defined by the Fatigue Scale for Motor and Cognitive Functions) took part in our validation study. Patients completed cFAST twice. We used t-tests, Monte Carlo sampling, and area under the receiver operating characteristic curves to evaluate our approach using two sets of proposed metrics.
When classifying fatigue, our fatigability metric has a mean area under the receiver operating characteristic curve of 0.74 (95% CI 0.64-0.84), making it the best performing metric for this task. Furthermore, shows a statistically significant difference between the fatigued and non-fatigued groups (t = 2.27, = .03). Particularly, cognitively-fatigued patients decline in performance, while non-fatigued patients do not.
We introduce cFAST, a new instrument to quantify cognitive fatigability. Our pilot study provides evidence that cognitive fatigability assessment test produces a quantifiable drop in cognitive performance in a short period. Furthermore, our results indicate that cFAST may have the potential to serve as a surrogate for subjective cognitive fatigue. cFAST is significantly shorter than the existing fatigability assessments and does not require specialized equipment. Thus, it could enable frequent and remote monitoring, which could substantially aid clinicians in better understanding and treating fatigue.
疲劳是包括多发性硬化症在内的许多疾病的常见症状。它表现为一种认知或身体状况。人们对疲劳的了解甚少，且缺乏有效的治疗方法。此外，还缺乏客观测量疲劳的方法。疲劳易感性，即在任务过程中可测量的表现下降，已被提议作为量化疲劳的一种补充方法。
开发一种新的客观测量认知疲劳易感性的方法，并研究其与感知疲劳的关联。
我们引入了认知疲劳易感性评估测试（cFAST），这是一种基于智能手机的新型测试，用于量化认知疲劳易感性。42名多发性硬化症患者（根据运动和认知功能疲劳量表定义，其中23名疲劳患者和19名非疲劳患者）参与了我们的验证研究。患者完成了两次cFAST测试。我们使用t检验、蒙特卡罗抽样以及受试者工作特征曲线下面积，使用两组提议的指标来评估我们的方法。
在对疲劳进行分类时，我们的疲劳易感性指标在受试者工作特征曲线下的平均面积为0.74（95%可信区间为0.64 - 0.84），使其成为该任务中表现最佳的指标。此外，疲劳组和非疲劳组之间存在统计学上的显著差异（t = 2.27，P = 0.03）。特别是，认知疲劳的患者表现下降，而非疲劳患者则没有。
我们引入了cFAST，这是一种量化认知疲劳易感性的新工具。我们的初步研究提供了证据，表明认知疲劳易感性评估测试在短时间内会导致认知表现出现可量化的下降。此外，我们的结果表明cFAST可能有潜力作为主观认知疲劳的替代指标。cFAST明显比现有的疲劳易感性评估方法更短，并且不需要专门设备。因此，它可以实现频繁的远程监测，这可以极大地帮助临床医生更好地理解和治疗疲劳。
