Jaekel Anke K, Watzek Julius, Nielsen Jörn, Butscher Anna-Lena, Bitter John, von Danwitz Marthe, Zöhrer Pirmin I, Knappe Franziska, Kirschner-Hermanns Ruth, Knüpfer Stephanie C
Department of Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany.
Department of Neuro-Urology, Johanniter Neurological Rehabilitation Center Godeshoehe GmbH, 53177 Bonn, Germany.
Biomedicines. 2025 Mar 1;13(3):601. doi: 10.3390/biomedicines13030601.
: Fatigue and depression are common symptoms of multiple sclerosis (MS) that severely impair quality of life. The factors influencing both are of increasing interest for establishing therapeutic synergisms. Correlations between the symptoms of neurogenic lower urinary tract dysfunction (NLUTD), fatigue, and depression have been described, but the impact of pathological urodynamic study (UDS) findings has not been investigated to date. : This retrospective, observational study correlated UDS findings of 274 people with MS (PwMS), prospectively collected between February 2017 and September 2021, with scores on the Fatigue Scale for Motor and Cognitive Functions and the German version of the Centre for Epidemiologic Studies Depression Scale. The effects of abnormal UDS on the FSMC and ADS scores were examined. Abnormal UDS was defined as follows: first desire to void (FDV) < 100 mL, strong desire to void < 250 mL (SDV), abnormal sensation, detrusor overactivity, detrusor-sphincter dyssynergia, reduced cystometric bladder capacity < 250 mL (MCBC), and compliance < 20 mL/cm HO (C). : PwMS with C (mean difference 3.21, 95% CI 0.25; 6.17, = 0.036) or FDV < 100 mL (mean difference 2.61, 95% CI 0.1; 5.12, = 0.041) had significantly higher FSMC mean values than those without. PwMS with MCBC < 250 mL (relative risk 1.06, 95% CI 1.02; 1.1, = 0.006) or C (relative risk 1.06, 95% CI 1.02; 1.1, = 0.004) had an increased risk of clinically relevant fatigue. No effects were found for depression. : PwMS with NLUTD have higher FSMC scores and an increased risk of fatigue in our retrospective study. The assessment of prospective longitudinal data regarding the effect of successfully treated NLUTD on fatigue is important for utilising therapeutic synergisms for improved quality of life in PwMS.
疲劳和抑郁是多发性硬化症(MS)的常见症状,严重损害生活质量。影响这两种症状的因素对于建立治疗协同作用越来越受到关注。神经源性下尿路功能障碍(NLUTD)的症状、疲劳和抑郁之间的相关性已有描述,但病理性尿动力学研究(UDS)结果的影响迄今尚未得到研究。:这项回顾性观察研究将2017年2月至2021年9月期间前瞻性收集的274例多发性硬化症患者(PwMS)的UDS结果与运动和认知功能疲劳量表以及德国版流行病学研究中心抑郁量表的得分进行了关联。研究了异常UDS对FSMC和ADS评分的影响。异常UDS的定义如下:首次排尿欲望(FDV)<100 mL、强烈排尿欲望<250 mL(SDV)、异常感觉、逼尿肌过度活动、逼尿肌-括约肌协同失调、膀胱容量测定值降低<250 mL(MCBC)以及顺应性<20 mL/cm H₂O(C)。:患有C(平均差异3.21,95%置信区间0.25;6.17,P = 0.036)或FDV<100 mL(平均差异2.61,95%置信区间0.1;5.12,P = 0.041)的PwMS的FSMC平均值显著高于无这些情况的患者。患有MCBC<250 mL(相对风险1.06,95%置信区间1.02;1.1,P = 0.006)或C(相对风险1.06,95%置信区间1.02;1.1,P = 0.004)的PwMS出现临床相关疲劳的风险增加。未发现对抑郁有影响。:在我们的回顾性研究中,患有NLUTD的PwMS具有更高的FSMC评分和更高的疲劳风险。评估成功治疗NLUTD对疲劳影响的前瞻性纵向数据对于利用治疗协同作用改善PwMS的生活质量很重要。