多发性硬化症中持续疲劳发作的基线预测因素:MS PATHS队列的纵向生存分析
Mahsa Ghajarzadeh1, Ellen M Mowry1, Bardia Nourbakhsh1
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Multiple sclerosis and related disorders
|December 11, 2025
概括
几乎四分之一的多发性硬化症 (MS) 患者最初没有疲劳,随着时间的推移,它发展了. 更高的身体残疾,抑郁和焦虑增加了风险,而更好的认知功能是保护性的.
科学领域:
- 神经学 神经学
- 临床研究 临床研究
- 公共卫生 公共卫生
背景情况:
- 疲劳是多发性硬化症 (MS) 的普遍和致残症状.
- 一些MS患者在诊断前会感到疲劳,而另一些患者在疾病进展过程中会感到疲劳.
- 确定持续疲劳的预测因素对于MS患者的积极管理至关重要.
研究的目的:
- 确定与在MS患者中持续疲劳的未来发展相关的因素,这些患者最初没有疲劳.
- 分析来自大量现实世界队列的纵向数据,以了解MS中疲劳发作.
主要方法:
- 从MS PATHS队列 (6,327名无疲劳参与者) 的数据进行纵向分析.
- 使用Neuro-QoL T-score切割点对基线疲劳的分类.
- 多变量到事件的时间和受限平均生存时间 (RMST) 分析,以确定3个月持续疲劳的预测因素.
主要成果:
- 在最初没有疲劳的参与者中,有23.1%的参与者在平均2.5年的随访期间出现了持续的疲劳.
- 持续疲劳的风险增加与更高的基线身体残疾 (PDDS),抑郁和焦虑有关.
- 较好的基线认知功能表明,对发展持续疲劳产生保护作用.
结论:
- 很大一部分MS患者最初没有疲劳,但在中期随访后会出现疲劳.
- 基线身体残疾,抑郁,焦虑和认知功能是MS中持续疲劳开始的关键预测因素.
- 这些发现可以为有针对性的干预措施提供信息,以减轻多发性硬化症中疲劳的影响.
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