Fatigue in Multiple Sclerosis by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783031134982
Publisher: Springer International Publishing

(2)Stanford Sleep Epidemiology Research Center, Stanford University, Stanford, CA, USA

(3)Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

U. Kallweit

Email: [email protected]

Sleep and/or wake disturbances exist in most neurological, especially neuroimmunological diseases. However, the complex interactions between the immune system, the nervous system and sleep-wake regulation are only recently becoming understood.

Narcolepsy can be cited as a model for this, where there is a significant decrease of so-called hypocretin-producing neurons, most probably through an autoimmune, most likely T-cell-mediated mechanism (Latorre et al. 2018). Hypocretin plays a central role in sleep-wake regulation and maintenance of stable, prolonged wakefulness. The reduction of hypocretin-producing cells results in hypocretin deficiency. This is then responsible for the symptoms of narcolepsy, including the repeated, sudden falling asleep during the day (Bassetti et al. 2019).

In multiple sclerosis (MS), autoimmune cellularly and humorally mediated pathomechanisms are prevalent and can be therapeutically targeted at least during certain disease stages. Mechanisms that lead to disturbances of sleep and wakefulness in MS however are unclear and presumably multifaceted. A connection between chronic inflammation and the occurrence of fatigue is being discussed (Patejdl et al. 2016).

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