Fatigue after a first attack of suspected multiple sclerosis

被引:14
作者
de Vries, Roos M. van der Vuurst [1 ]
van den Dorpel, Jan J. A. [1 ]
Mescheriakova, Julia Y. [1 ]
Runia, Tessel F. [1 ]
Jafari, Naghmeh [1 ]
Siepman, Theodora A. M. [1 ]
Rizopoulos, Dimitris [2 ]
Steyerberg, Ewout W. [3 ]
Hintzen, Rogier Q. [1 ]
机构
[1] Erasmus MC, Dept Neurol, MS Ctr ErasMS, Room Ee2230,POB 2040, NL-3000 CA Rotterdam, Netherlands
[2] Erasmus MC, Dept Biostat, Rotterdam, Netherlands
[3] Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands
关键词
Clinically isolated syndrome; CIS; multiple sclerosis; early MS; fatigue; prognosis; SEVERITY SCALE; HOSPITAL ANXIETY; DEPRESSION SCALE; DIAGNOSIS; TIME; PREVALENCE; DISABILITY;
D O I
10.1177/1352458517709348
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Fatigue is reported by more than 75% of multiple sclerosis (MS) patients. In an earlier study, we showed that fatigue is not only a common symptom in patients at time of clinically isolated syndrome (CIS; fatigued 46%) but also predicts subsequent diagnosis of clinically definite multiple sclerosis (CDMS). The course of fatigue after CIS is unknown. Objective: We aimed to explore the long-term course of fatigue after CIS. Methods: In this study, 235 CIS patients, aged 18-50years, were prospectively followed. Patients filled in the Krupp's Fatigue Severity Scale (FSS) and the Hospital Anxiety and Depression Scale (HADS) at baseline and annually. After reaching CDMS diagnosis, Expanded Disability Status Scale (EDSS) was obtained annually. Mixed-effects models were used to analyse longitudinal FSS measurements. Results: Fatigue at baseline was an independent predictor for CDMS diagnosis (hazard ratio (HR): 2.6, 95% confidence interval (CI): 1.6-4.4). The evolution of FSS was the same in CIS patients who remained monophasic and patients who were diagnosed with CDMS during follow-up. However, FSS increased by 0.86 units after reaching CDMS diagnosis (p=0.01). After this increase, the FSS course remained unaltered (p=0.44). Conclusion: Fatigue, which is often present at time of CIS, probably persists over time and increases after a second attack.
引用
收藏
页码:974 / 981
页数:8
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