En el episodio de hoy, os traigo un tema muy presente en neurorrehabilitación y en las consultas de neurología en relación con la esclerosis múltiple y es nada menos que la fatiga. La fatiga, ese síntoma tan temido desde siempre, tanto por pacientes como por profesionales de la salud, que es uno de los más reportados, con cifras de prevalencia entre 52 y el 90% de los pacientes (Nagaraj et al., 2013). Indagamos en la fisiopatología de la fatiga para entender mejor este fenómeno, también diferentes formas de ver la fatiga con sus distintas nomenclaturas o términos, vamos a ver cómo se suele evaluar en el entorno clínico y en investigación y finalmente daremos algunas pinceladas de tratamiento neuromodulador. Referencias del episodio: 1. Adibi, I., Sanayei, M., Tabibian, F., Ramezani, N., Pourmohammadi, A., & Azimzadeh, K. (2022). Multiple sclerosis-related fatigue lacks a unified definition: A narrative review. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 24. https://doi.org/10.4103/jrms.jrms_1401_20 (https://pubmed.ncbi.nlm.nih.gov/35419061/). 2. Ayache, S. S., & Chalah, M. A. (2017). Fatigue in multiple sclerosis - Insights into evaluation and management. Neurophysiologie clinique = Clinical neurophysiology, 47(2), 139–171. https://doi.org/10.1016/j.neucli.2017.02.004 (https://pubmed.ncbi.nlm.nih.gov/28416274/). 3. Ayache, S. S., Serratrice, N., Abi Lahoud, G. N., & Chalah, M. A. (2022). Fatigue in Multiple Sclerosis: A Review of the Exploratory and Therapeutic Potential of Non-Invasive Brain Stimulation. Frontiers in neurology, 13, 813965. https://doi.org/10.3389/fneur.2022.813965 (https://pubmed.ncbi.nlm.nih.gov/35572947/). 4. Bhattarai, J. J., Patel, K. S., Dunn, K. M., Brown, A., Opelt, B., & Hughes, A. J. (2023). Sleep disturbance and fatigue in multiple sclerosis: A systematic review and meta-analysis. Multiple sclerosis journal - experimental, translational and clinical, 9(3), 20552173231194352. https://doi.org/10.1177/20552173231194352 (https://pubmed.ncbi.nlm.nih.gov/37641617/). 5. Braley, T. J., & Chervin, R. D. (2010). Fatigue in multiple sclerosis: mechanisms, evaluation, and treatment. Sleep, 33(8), 1061–1067. https://doi.org/10.1093/sleep/33.8.1061 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910465/). 6. Capone, F., Motolese, F., Falato, E., Rossi, M., & Di Lazzaro, V. (2020). The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue. Frontiers in neurology, 11, 251. https://doi.org/10.3389/fneur.2020.00251 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212459/). 7. Chalah, M. A., Riachi, N., Ahdab, R., Créange, A., Lefaucheur, J. P., & Ayache, S. S. (2015). Fatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation. Frontiers in cellular neuroscience, 9, 460. https://doi.org/10.3389/fncel.2015.00460 (https://pubmed.ncbi.nlm.nih.gov/26648845/). 8. Chalah, M. A., Kauv, P., Créange, A., Hodel, J., Lefaucheur, J. P., & Ayache, S. S. (2019). Neurophysiological, radiological and neuropsychological evaluation of fatigue in multiple sclerosis. Multiple sclerosis and related disorders, 28, 145–152. https://doi.org/10.1016/j.msard.2018.12.029 (https://pubmed.ncbi.nlm.nih.gov/30594815/). 9. Dittner, A. J., Wessely, S. C., & Brown, R. G. (2004). The assessment of fatigue: a practical guide for clinicians and researchers. Journal of psychosomatic research, 56(2), 157–170. https://doi.org/10.1016/S0022-3999(03)00371-4 (https://pubmed.ncbi.nlm.nih.gov/15016573/). 10. Dobryakova, E., Genova, H. M., DeLuca, J., & Wylie, G. R. (2015). The dopamine imbalance hypothesis of fatigue in multiple sclerosis and other neurological disorders. Frontiers in neurology, 6, 52. https://doi.org/10.3389/fneur.2015.00052 (https://pubmed.ncbi.nlm.nih.gov/25814977/). 11. Freal, J. E., Kraft, G. H., & Coryell, J. K. (1984). Symptomatic fatigue in multiple sclerosis. Archives of physical medicine and rehabilitation, 65(3), 135–138 (https://pubmed.ncbi.nlm.nih.gov/6703889/). 12. Gaede, G., Tiede, M., Lorenz, I., Brandt, A. U., Pfueller, C., Dörr, J., Bellmann-Strobl, J., Piper, S. K., Roth, Y., Zangen, A., Schippling, S., & Paul, F. (2017). Safety and preliminary efficacy of deep transcranial magnetic stimulation in MS-related fatigue. Neurology(R) neuroimmunology & neuroinflammation, 5(1), e423. https://doi.org/10.1212/NXI.0000000000000423 (https://pubmed.ncbi.nlm.nih.gov/29259998/). 13. Garis, G., Haupts, M., Duning, T., & Hildebrandt, H. (2023). Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 44(1), 83–98. https://doi.org/10.1007/s10072-022-06385-1 (https://pubmed.ncbi.nlm.nih.gov/36125573/). 14. Hanken, K., Eling, P., & Hildebrandt, H. (2014). The ...
