Royer Nicolas, Coates Kyla, Aboodarda Saied Jalal, Camdessanché Jean-Philippe, Millet Guillaume Y
Inter-University Laboratory of Human Movement Biology, University of Lyon, UJM-Saint-Etienne, Saint-Etienne, France.
School of Exercise and Health Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Kelowna, BC, Canada.
Front Neurol. 2022 Oct 17;13:983643. doi: 10.3389/fneur.2022.983643. eCollection 2022.
Whereas fatigue is recognized to be the main complaint of patients with multiple sclerosis (PwMS), its etiology, and particularly the role of resistance to fatigability and its interplay with disability level, remains unclear. The purposes of this review were to (i) clarify the relationship between fatigue/disability and neuromuscular performance in PwMS and (ii) review the corticospinal and muscular mechanisms of voluntary muscle contraction that are altered by multiple sclerosis, and how they may be influenced by disability level or fatigue. Neuromuscular function at rest and during exercise are more susceptible to impairement, due to deficits in voluntary activation, when the disability is greater. Fatigue level is related to resistance to fatigability but not to neuromuscular function at rest. Neurophysiological parameters related to signal transmission such as central motor conduction time, motor evoked potentials amplitude and latency are affected by disability and fatigue levels but their relative role in the impaired production of torque remain unclear. Nonetheless, cortical reorganization represents the most likely explanation for the heightened fatigability during exercise for highly fatigued and/or disabled PwMS. Further research is needed to decipher how the fatigue and disability could influence fatigability for an ecological task, especially at the corticospinal level.
尽管疲劳被认为是多发性硬化症患者（PwMS）的主要主诉，但其病因，尤其是抗疲劳能力的作用及其与残疾程度的相互作用仍不清楚。本综述的目的是：（i）阐明PwMS患者疲劳/残疾与神经肌肉功能之间的关系；（ii）综述多发性硬化症改变的随意肌肉收缩的皮质脊髓和肌肉机制，以及它们如何受到残疾程度或疲劳的影响。当残疾程度较高时，由于随意激活不足，静息和运动期间的神经肌肉功能更容易受到损害。疲劳程度与抗疲劳能力有关，但与静息时的神经肌肉功能无关。与信号传递相关的神经生理参数，如中枢运动传导时间、运动诱发电位幅度和潜伏期，受残疾和疲劳程度影响，但其在扭矩产生受损中的相对作用仍不清楚。尽管如此，皮质重组最有可能解释高度疲劳和/或残疾的PwMS患者运动期间疲劳加剧的原因。需要进一步研究来解读疲劳和残疾如何影响生态任务中的疲劳能力，尤其是在皮质脊髓水平。
