Fatigue Impacts Quality of Life in People with Spinocerebellar Ataxias

Author:

Lai Ruo‐Yah12ORCID,Rummey Christian3,Amlang Christian J.124,Lin Chi‐Ying R.5ORCID,Chen Tiffany X.126ORCID,Perlman Susan7,Wilmot George8,Gomez Christopher M.9,Schmahmann Jeremy D.10ORCID,Paulson Henry11,Ying Sarah H.12,Onyike Chiadi U.12,Zesiewicz Theresa A.13ORCID,Bushara Khalaf O.14,Geschwind Michael D.15,Figueroa Karla P.16,Pulst Stefan M.16,Subramony Sub H.17,Burns Matthew R.17,Opal Puneet18,Duquette Antoine19,Ashizawa Tetsuo20ORCID,Hamedani Ali G.21,Davis Marie Y.2223ORCID,Srinivasan Sharan R.11,Moore Lauren R.24,Shakkottai Vikram G.25,Rosenthal Liana S.26ORCID,Kuo Sheng‐Han12

Affiliation:

1. Department of Neurology Columbia University Medical Center New York New York USA

2. Initiative of Columbia Ataxia and Tremor Columbia University Irving Medical Center New York New York USA

3. Clinical Data Science Basel Switzerland

4. Department of Neurology SUNY Downstate Health Sciences University Brooklyn, New York New York USA

5. Alzheimer's Disease and Parkinson's Disease Centers, Department of Neurology Baylor College of Medicine Houston Texas USA

6. Department of Biomedical Engineering, Whiting School of Engineering Johns Hopkins University Baltimore Maryland USA

7. Department of Neurology University of California Los Angeles Los Angeles California USA

8. Department of Neurology Emory University Atlanta Georgia USA

9. Department of Neurology University of Chicago Chicago Illinois USA

10. Ataxia Center, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Cognitive Behavioral Neurology Unit, Department of Neurology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA

11. Department of Neurology University of Michigan Ann Arbor Michigan USA

12. Department of Psychiatry and Behavioral Sciences Johns Hopkins University Baltimore Maryland USA

13. Department of Neurology University of South Florida Tampa Florida USA

14. Department of Neurology University of Minnesota Minneapolis Minnesota USA

15. Department of Neurology University of California San Francisco San Francisco California USA

16. Department of Neurology University of Utah Salt Lake City Utah USA

17. Department of Neurology, McKnight Brain Institute University of Florida Gainesville Florida USA

18. Department of Neurology Northwestern University Chicago Illinois USA

19. Centre Hospitalier de l'Université de Montréal University of Montreal Montreal Quebec Canada

20. Houston Methodist Research Institute Houston Texas USA

21. Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA

22. Department of Neurology University of Washington Seattle Washington USA

23. Neurology Division VA Puget Sound Health Care System Seattle WA United States

24. National Ataxia Foundation Minneapolis Minnesota USA

25. Department of Neurology University of Texas Southwestern Medical Center Dallas Texas USA

26. Department of Neurology Johns Hopkins University Baltimore Maryland USA

Abstract

ABSTRACTBackgroundFatigue is a prevalent and debilitating symptom in neurological disorders, including spinocerebellar ataxias (SCAs). However, the risk factors of fatigue in the SCAs as well as its impact have not been well investigated.ObjectivesTo study the prevalence of fatigue in SCAs, the factors contributing to fatigue, and the influence of fatigue on quality of life.MethodsFatigue was assessed in 418 participants with SCA1, SCA2, SCA3, and SCA6 from the Clinical Research Consortium for the Study of Cerebellar Ataxia using the Fatigue Severity Scale. We conducted multi‐variable linear regression models to examine the factors contributing to fatigue as well as the association between fatigue and quality of life.ResultsFatigue was most prevalent in SCA3 (52.6%), followed by SCA1 (36.7%), SCA6 (35.7%), and SCA2 (35.6%). SCA cases with fatigue had more severe ataxia and worse depressive symptoms. In SCA3, those with fatigue had a longer disease duration and longer pathological CAG repeat numbers. In multi‐variable models, depressive symptoms, but not ataxia severity, were associated with more severe fatigue. Fatigue, independent of ataxia and depression, contributed to worse quality of life in SCA3 and SCA6 at baseline, and fatigue continued affecting quality of life throughout the disease course in all types of SCA.ConclusionsFatigue is a common symptom in SCAs and is closely related to depression. Fatigue significantly impacts patients' quality of life. Therefore, screening for fatigue should be considered a part of standard clinical care for SCAs.

Funder

National Ataxia Foundation

National Institutes of Health

Publisher

Wiley

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