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@ARTICLE{Vogt:153435,
      author       = {Vogt, Susanne and Schreiber, Stefanie and Pfau, Giselher
                      and Kollewe, Katja and Heinze, Hans-Jochen and Dengler,
                      Reinhard and Petri, Susanne and Vielhaber, Stefan and
                      Brinkers, Michael},
      title        = {{D}yspnea as a {F}atigue-{P}romoting {F}actor in {ALS} and
                      the {R}ole of {O}bjective {I}ndicators of {R}espiratory
                      {I}mpairment},
      journal      = {Journal of pain and symptom management},
      volume       = {60},
      number       = {2},
      issn         = {0885-3924},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DZNE-2020-01432},
      pages        = {430 - 438.e1},
      year         = {2020},
      abstract     = {ContextThere is no evidence-based treatment for fatigue in
                      amyotrophic lateral sclerosis (ALS), and identification of
                      treatable causes determines management strategies. Although
                      dyspnea is a key symptom of ALS and effectively treatable,
                      it has not been sufficiently investigated whether dyspnea
                      may be a fatigue-promoting factor.ObjectivesTo determine the
                      level of fatigue in dyspneic ALS patients and whether
                      fatigue is promoted by dyspnea. We further evaluated the
                      correlation of fatigue with respiratory function
                      tests.MethodsAbout 101 dyspneic patients and 20 matched
                      controls completed the ALS Functional Rating
                      Scale—Extension and the Fatigue Severity Scale. Dyspneic
                      patients additionally completed the Dyspnea-ALS Scale and
                      the ALS Assessment Questionnaire and underwent respiratory
                      function tests (forced vital capacity, sniff nasal
                      inspiratory pressure, mean inspiratory and expiratory
                      pressure with respective relaxation rates, and blood gases).
                      Multiple regression and correlation analyses were
                      conducted.ResultsDyspneic patients had significantly higher
                      fatigue scores than nondyspneic patients, and their fatigue
                      significantly affected quality of life. Dyspnea alone
                      explained up to $24\%$ of the variance in fatigue. No
                      associations were observed between fatigue and respiratory
                      function tests. Patients with noninvasive ventilation
                      reported significantly more dyspnea and
                      fatigue.ConclusionFatigue is a frequent and bothersome
                      symptom in dyspneic ALS patients. Dyspnea-related distress
                      is, in contrast to objective indicators of respiratory
                      impairment, a determining factor of experienced fatigue.
                      There is an urgent need for further symptom relief beyond
                      noninvasive ventilation. Adequate treatment of dyspnea has
                      the potential for synergies in symptom management arising
                      from the association between fatigue and dyspnea.},
      keywords     = {Amyotrophic Lateral Sclerosis: complications / Amyotrophic
                      Lateral Sclerosis: diagnosis / Amyotrophic Lateral
                      Sclerosis: therapy / Dyspnea: diagnosis / Dyspnea: etiology
                      / Dyspnea: therapy / Fatigue: diagnosis / Fatigue: etiology
                      / Fatigue: therapy / Humans / Quality of Life / Respiratory
                      Insufficiency},
      cin          = {U Clinical Researchers - Magdeburg / AG Düzel},
      ddc          = {610},
      cid          = {I:(DE-2719)7000000 / I:(DE-2719)5000006},
      pnm          = {342 - Disease Mechanisms and Model Systems (POF3-342) / 344
                      - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-342 / G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32145336},
      doi          = {10.1016/j.jpainsymman.2020.02.021},
      url          = {https://pub.dzne.de/record/153435},
}