Prevalence of fatigue in patients with multiple system atrophy and its relationship with depression
Objective Fatigue is one of the common disabling non-motor symptoms of multiple system atrophy(MSA).This study aimed to investigate the prevalence of fatigue in MSA patients and its relationship with anxiety and depression.Methods In this cross-sectional study,44 MSA inpatients from Xuanwu Hospital of Capital Medical University were enrolled.Fatigue was defined as a Fatigue Severity Scale(FSS)score ≥4.The motor symptoms of the patients were evaluated using the Unified Parkinson's Disease Rating Scale(MDS-UPDRS)and Unified Multi-System Atrophy Rating Scale(UMSARS).The Hamilton Rating Scale for Depression(HAMD),Geriatric Depression Scale(GDS)and Hamilton Anxiety Scale(HAMA)were used to assess anxiety and depression.Results The mean age of the MSA patients was 60.1±6.4 years,and the score of FSS was 4.3±2.4,with 28 patients(63.6％)having fatigue.Compared with the non-fatigue group,the fatigue group showed clear anxiety(HAMA:16.5±8.9 vs.9.4±5.0,t=-2.292,P=0.010)and depression(HAMD:14.4±7.0 vs.8.4±3.4,t=6.192,P=0.017;GDS:18.2±7.4 vs.10.7±5.2,t=-3.560,P=0.044).The severity of fatigue in MSA patients was positively correlated with anxiety(r=0.516,P＜0.001),depression(HAMD:r=0.551,P＜0.001;GDS:r=0.636,P=0.000)and the score of activities of daily living(r=0.320,P=0.034),but not correlated with motor symptoms or disease severity.Conclusions Nearly two-thirds of MSA patients have symptoms of fatigue,and fatigue is significantly associated with levels of anxiety and depression,affecting patients'mood and activities of daily living.
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