多发性硬化症患者认知疲劳的病因、表现和评价的综合综述

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引用次数: 0

摘要

背景:疲劳是多发性硬化症(MS)患者最明显的症状,对其中一些患者来说,疲劳可能会导致残疾。探索多发性硬化症相关疲劳的研究将其分为不同的维度:运动、认知、身体、社会心理、表现和主观。这是认知层面可能产生严重后果,如丧失职业、独立性,并可能导致更多的疾病复发或恶化。目的:本综合综述的目的是探讨对多发性硬化症认知疲劳及其原因和表现的认识进展,并确定最佳测量多发性硬化症认知疲劳的客观方法。方法学:采用PRISMA-P2015数据提取指南的方法和标准对科学文献进行综合综述。采用快速批判性评价和不断比较的定性研究方法对研究进行批判性评价。结果:从美国和其他国家确定了23项研究(2010-2019)。大部分文章都是在最近三年内发表的。通过自我报告对这些研究的结果进行评估。认知疲劳在复发和缓解型MS患者以及继发性进展型MS患者中可能导致更多的复发。认知疲劳和身体疲劳应被视为不同的领域。结论和建议:越来越多的研究关注认知疲劳,然而,没有标准的定义或概念框架可用于理解这一现象。确定了各种方法来评估认知疲劳。此外,应该有一个有效的,可靠的,并易于获得的仪器用于临床设置。关键词:多发性硬化症;认知疲劳;疲劳
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An Integrative Review of Causes, Manifestations and Evaluation of Cognitive Fatigue among Persons with Multiple Sclerosis
Background: Fatigue is the most distinguishing symptom for patients with Multiple Sclerosis (MS) and for some of these patients it can be quite disabling. Studies exploring MS-related fatigue have differentiated this into various dimensions: motor, cognitive, physical, psychosocial, performance, and subjective. It is the cognitive dimension that can have serious consequences such as loss of vocation, independence, and possibly, more relapses or worsening of the disease. Objective: The aims of this integrative review were to explore the advances in understanding cognitive fatigue in MS, as well as its causes and manifestations, and to identify the objective methodologies that best measure cognitive fatigue in MS. Methodology: An integrative review of the scientific literature was performed using methods and criteria following the PRISMA-P2015 guidelines for data extraction. The studies were critically appraised using the Rapid Critical Appraisal and the qualitative study method of Constant Comparison. Results: Twenty-three studies (2010-2019) were identified from the United States and other countries. The majority of articles were published within the last three years. Evaluation of outcomes from these studies was conducted through self-reporting. Cognitive fatigue may result in more relapses among those with relapsing and remitting MS and from those with secondary progressive MS. Cognitive fatigue and physical fatigue should be considered distinct domains. Conclusion and Recommendations: An increasing number of studies focused on cognitive fatigue, however, there is no standard definition or conceptual framework available to understand this phenomenon. Various methodologies were identified to evaluate cognitive fatigue. Additionally, there should be a valid, reliable, and readily available instrument for use in the clinical setting. Keywords: Multiple Sclerosis, Cognitive Fatigue, Fatigue, Integrative Review
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