McComas A J, Miller R G, Gandevia S C
Department of Biomedical Sciences, McMaster University, Hamilton, Canada.
Adv Exp Med Biol. 1995;384:495-512. doi: 10.1007/978-1-4899-1016-5_38.
Increased fatigability necessarily occurs in every patient with muscle weakness, regardless of whether the latter is due to a central or peripheral neurological disorder. The tendency for disuse to increase fatigability, as a secondary phenomenon, must also be considered; disuse affects both motoneuron recruitment and the biochemical and physiological properties of the muscle fibers. In recent studies impaired recruitment has been observed in postpolio patients, while patients with multiple sclerosis or spinal cord injury have shown, in addition, altered neuromuscular function. Findings are also presented in ALS and the chronic fatigue syndrome. In general, the most dramatic increases in fatigability take place in disorders of the peripheral nervous system and almost any cell component can be incriminated. There is a need to study fatigability systematically in neurology and rehabilitation.
每一位肌无力患者必然会出现疲劳性增加的情况，无论肌无力是由中枢神经系统还是周围神经系统疾病引起的。作为一种继发现象，还必须考虑废用导致疲劳性增加的倾向；废用会影响运动神经元的募集以及肌纤维的生化和生理特性。在最近的研究中，观察到小儿麻痹后遗症患者存在募集受损的情况，而多发性硬化症或脊髓损伤患者除了神经肌肉功能改变外，也有类似情况。肌萎缩侧索硬化症和慢性疲劳综合征也有相关研究结果。一般来说，疲劳性增加最为显著的情况发生在周围神经系统疾病中，几乎任何细胞成分都可能是原因所在。神经病学和康复领域有必要对疲劳性进行系统研究。
