Journal Article

DZNE-2020-01432

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Dyspnea as a Fatigue-Promoting Factor in ALS and the Role of Objective Indicators of Respiratory Impairment

Vogt, S. (Corresponding author) ; Schreiber, S. ; Pfau, G. ; Kollewe, K. ; Heinze, H.-J.DZNE* ; Dengler, R. ; Petri, S. ; Vielhaber, S.DZNE* ; Brinkers, M.

2020
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.jpainsymman.2020.02.021

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.

Keyword(s): Amyotrophic Lateral Sclerosis: complications (MeSH) ; Amyotrophic Lateral Sclerosis: diagnosis (MeSH) ; Amyotrophic Lateral Sclerosis: therapy (MeSH) ; Dyspnea: diagnosis (MeSH) ; Dyspnea: etiology (MeSH) ; Dyspnea: therapy (MeSH) ; Fatigue: diagnosis (MeSH) ; Fatigue: etiology (MeSH) ; Fatigue: therapy (MeSH) ; Humans (MeSH) ; Quality of Life (MeSH) ; Respiratory Insufficiency (MeSH)

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Contributing Institute(s):

1. U Clinical Researchers - Magdeburg (U Clinical Researchers - Magdeburg)
2. Clinical Neurophysiology and Memory (AG Düzel)

Research Program(s):

1. 342 - Disease Mechanisms and Model Systems (POF3-342) (POF3-342)
2. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2020

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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