Abstract:
:This review will update current views of the physiopathology and treatment of fatigue in multiple sclerosis. Fatigue is a common symptom in multiple sclerosis, being reported by about a third of the patients. For many of them it is the most disabling symptom, with negative consequences on working activity and daily life. There are no objective measures of fatigue which is essentially based on subjective complaints. Even if fatigue may be influenced by motor disturbances and depression, it is largely independent from both. Peripheral mechanisms, such as muscular disuse and deconditioning, joint abnormalities and metabolic changes of muscular fibers, have very little role in multiple sclerosis fatigue. All the available data indicate that fatigue is a 'central' phenomenon, due to multiple causes. Neurophysiological studies revealed an impairment of volitional drive to the descending motor pathways and functional imaging studies fund a selective involvement of frontal cortex and basal ganglia. Therefore, a dysfunction of the circuits between thalamus, basal ganglia and frontal cortex, affected by the multiple sclerosis lesions and/or disturbed in their function by the products of inflammation could be the substrate of fatigue. No specific treatments are available - management strategies include medications, exercise and behavioral therapy - in most cases a combined approach is suitable. Enhancers of vigilance, like amantadine and modafinil, were shown to be effective in class I and II trials, however their effects are modest. Aminopyridines may indirectly influence fatigue by reducing nerve conduction block in motor fibers. Some recent studies suggest the positive effects of drugs on fatigue may be via reducing the inflammatory activity, such as for glatiramer acetate.
journal_name
Expert Rev Neurotherjournal_title
Expert review of neurotherapeuticsauthors
Comi G,Leocani Ldoi
10.1586/14737175.2.6.867subject
Has Abstractpub_date
2002-11-01 00:00:00pages
867-76issue
6eissn
1473-7175issn
1744-8360journal_volume
2pub_type
杂志文章abstract::With increasing life expectancy, the early diagnosis and treatment of Alzheimer's disease has become critical in sustaining a healthy society. Noninvasive markers of disease progression starting from the earliest stages of pathologic involvement are required for determining the effectiveness of putative disease-modify...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.5.5.663
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journal_title:Expert review of neurotherapeutics
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2016.1135736
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journal_title:Expert review of neurotherapeutics
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journal_title:Expert review of neurotherapeutics
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
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更新日期:2011-08-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
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更新日期:2001-11-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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更新日期:2007-06-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2014.863710
更新日期:2014-01-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.8.4.575
更新日期:2008-04-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
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更新日期:2010-07-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
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journal_title:Expert review of neurotherapeutics
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更新日期:2006-03-01 00:00:00
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journal_title:Expert review of neurotherapeutics
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更新日期:2012-07-01 00:00:00
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journal_title:Expert review of neurotherapeutics
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更新日期:2004-05-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.6.7.1077
更新日期:2006-07-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2016.1194757
更新日期:2016-09-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2015.1101345
更新日期:2015-01-01 00:00:00
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journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.3.5.591
更新日期:2003-09-01 00:00:00