Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis
Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis
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DOI：
10.1212/wnl.0000000000001939
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发表时间：
2015-11-10
期刊：
影响因子：
9.9
通讯作者：
Yeh, E. Ann
中科院分区：
文献类型：
--
作者：
Grover, Stephanie A.;Aubert-Broche, Berengere;Yeh, E. Ann
目的：评估一组患有 MS 和单相获得性脱髓鞘综合征 (mono-ADS) 的儿童中体力活动 (PA) 与多发性硬化症 (MS) 疾病活动、抑郁和疲劳之间的关联。方法：在这项对就诊于专门儿科 MS 诊所的连续患者进行的横断面研究中，我们使用了 PedsQL 多维疲劳量表、流行病学研究中心抑郁量表和 Godin 休闲运动问卷。进行定量 MRI 分析以获得参与者子集 (n = 60) 的全脑和 T2 病变体积。结果：总共纳入 110 名患者（79 名单 ADS；31 名 MS；5-18 岁；M:F 1:1.2）。与单 ADS 患者相比，MS 患者报告的剧烈运动量（33.21 ± 31.88 代谢当量 [MET] 对比 15.97 +/- 22.73 METs，p = 0.002）和总 PA（44.48 +/- 39.35 METs 对比 67.28 +/- 59.65 METs；p = 0.0291）较少。报告中度 PA MET 含量较高的多发性硬化症患者的睡眠/休息疲劳症状较少 (r = -0.4)。参加剧烈的 PA 与较小的 T2 病变体积 (r = -0.66) 和较低的年复发率 (r = -0.66) 相关。未发现总脑容量与参与 PA 之间存在关联。结论：患有 MS 的儿童比患有单一 ADS 的儿童身体活动较少。其原因尚不清楚，但可能与持续的疾病活动、感知的限制或抑郁或疲劳等症状有关。患有 MS 的儿童报告剧烈 PA 水平较高，T2 病变体积较小，复发率较低，表明剧烈 PA 对该人群具有潜在的保护作用。需要进一步的纵向研究来确定该人群中 PA 与 MS 症状和疾病活动的关系。
Objective:To evaluate the association between physical activity (PA) and multiple sclerosis (MS) disease activity, depression, and fatigue in a cohort of children with MS and monophasic acquired demyelinating syndrome (mono-ADS).Methods:In this cross-sectional study of consecutive patients attending a specialized pediatric MS clinic, we administered the PedsQL Multidimensional Fatigue Scale, Center for Epidemiological Studies Depression Scale, and Godin Leisure-Time Exercise Questionnaire. Quantitative MRI analysis was performed to obtain whole brain and T2 lesion volume in a subset of participants (n = 60).Results:A total of 110 patients (79 mono-ADS; 31 MS; 5-18 years; M:F 1:1.2) were included. Patients with MS reported less strenuous (33.21 31.88 metabolic equivalents [METs] vs 15.97 +/- 22.73 METs, p = 0.002) and total (44.48 +/- 39.35 METs vs 67.28 +/- 59.65 METs; p = 0.0291) PA than those with mono-ADS. Patients with MS who reported greater amounts of moderate PA METs had fewer sleep/rest fatigue symptoms (r = -0.4). Participation in strenuous PA was associated with smaller T2 lesion volumes (r = -0.66) and lower annualized relapse rate (r = -0.66). No associations were found between total brain volume and participation in PA.Conclusions:Children with MS are less physically active than children with mono-ADS. Reasons for this are unclear, but may be related to ongoing disease activity, perceived limitations, or symptoms such as depression or fatigue. Children with MS reporting higher levels of strenuous PA had lower T2 lesion volumes and lower relapse rates, suggesting a potential protective effect of strenuous PA in this population. Further longitudinal studies are needed to establish the relationship of PA to MS symptoms and disease activity in this population.