Investigating Correlates and Therapeutics of Fatigue

疲劳是一种全球性的医疗体验。它被定义为缺乏能量和压倒性的疲劳感，与悲伤或虚弱区分开来。疲劳通常与其他症状和行为（如抑郁症）聚集在一起，并且与许多医学状况有关，包括神经系统疾病（如帕金森病），自身免疫性疾病（如干燥综合征），并且与治疗有关，例如那些正在接受或完成癌症治疗的人。也有不同的综合征，疲劳是主要症状，如慢性疲劳综合征，纤维肌痛，或长期COVID。疲劳的主要原因仍然知之甚少。其他人则认为，疲劳有生物学基础，例如炎症反应失调或应激反应功能障碍，甚至神经细胞代谢紊乱，或者可能是去甲肾上腺素和血清素等神经递质水平降低。当试图理解疲劳时，需要考虑的其他因素是它与抑郁症等其他症状的关系。一些研究表明，抑郁和疲劳的关系可能是双向的，这意味着这些条件可能有共同的机制。这一共同机制的主张被特定的免疫标记物与疲劳和抑郁症相关的事实所证明。其他人则反对这种共同机制假设，因为抑郁症状可能会通过药物治疗得到改善，而疲劳症状则是抵抗性的。我们的调查使用标准化问卷描述了不同临床人群（癌症患者、纤维肌痛患者、慢性疲劳综合征患者、干燥综合征患者、类风湿性关节炎患者、系统性红斑狼疮患者和长期COVID患者）的疲劳症状，并确定体力活动、疼痛、抑郁、疲劳灾难化、压力和睡眠是否在他们的疲劳体验中发挥作用。这项研究还将研究生物过程的潜在作用，如炎症和代谢在这些人的疲劳。我们也有兴趣看看健康的社会决定因素，如他们的共病慢性病，他们的社区环境，他们的健康状况，获得医疗保健的财务压力，以及他们所在地的气候变化如何影响他们的症状体验。从这项调查中收集的信息将有助于提高我们对疲劳的理解，并确定可能的目标，以开发治疗方法来缓解这种令人痛苦的症状。

Fatigue is a global experience across medical conditions. It is defined as a lack of energy and an overwhelming sense of tiredness that is distinguishable from sadness or weakness. Fatigue is often clustered with other symptoms and behaviors like depression, and has been associated with many medical conditions, including neurological diseases such as Parkinson's disease, autoimmune diseases such Sjogren's syndrome, and have been associated with treatments, such as those who are receiving or who completed cancer treatments. There are also different syndromes where fatigue presents as a main symptom, like chronic fatigue syndrome, fibromyalgia, or those suffering from long COVID. The main cause of fatigue remains poorly understood. Others argue that there is a biologic basis to explain fatigue such as dysregulation of inflammatory response or dysfunction in stress response or even disturbances in the metabolism of nerve cells, or perhaps decreased levels of neurotransmitters such as norepinephrine and serotonin. Other factors to consider when trying to understand fatigue is its relationship with other symptoms like depression. Some studies have shown that the relationship of depression and fatigue may be bidirectional, implying that these conditions may have shared mechanisms. This proposition for a shared mechanism is evidenced by the fact that specific immune markers are associated with both fatigue and depression. Others argue against this shared mechanism hypothesis, as depressive symptoms may improve with pharmacotherapy, while symptoms of fatigue are resistive. Our investigation characterizes the symptoms of fatigue from different clinical populations (cancer patients, patients with fibromyalgia, chronic fatigue syndrome, Sjogren's syndrome, rheumatoid arthritis, Systemic Lupus Erythematosus, and those suffering from long COVID) using standardized questionnaires and determine if physical activity, pain, depression, fatigue catastrophizing, stress, and sleep play a role in their fatigue experience. This study will also examine the potential role of biologic processes such as inflammation and metabolism in fatigue for these individuals. We are also interested in looking at how social determinants of health like their comorbid chronic conditions, their community environment, financial stress from their health conditions, access to healthcare, and climate changes in their location affect their symptom experience. Information collected from this investigation will be useful to improve our understanding of fatigue and identify possible targets to develop therapeutics to alleviate this distressing symptom.