Nowadays there is a growing interest in finding new interventions to face debilitating symptoms of patients on chronic conditions. Among these, fatigue is a common symptom experienced by patients affected by end-stage renal failure on chronic hemodialysis (HD) that significantly affects their quality of life (QoL). Recently, research on neuro-immune interactions has demonstrated that an alteration of the basal ganglia function, regulated by dopamine, may translate in a reduced motivation and altered reward processes in other chronic diseases, such as hemodialysis patients. Thus, the aim of this study was to investigate a possible correlation between the severity of fatigue and the reward mechanisms that regulate the motivational behaviours, and how these mechanisms are affected in HD patients with a significant impact on their QoL. Evaluative scales have been administered to a sample of haemodialysis patients (N=94) older than 18 years, with no neurocognitive disease. Fatigue Severity Scale (FSS) has been applied to measure the impact of fatigue on motivation and social functionality. BIS/BAS Scale has been administered to investigate the mechanisms of reward: Behavioural Activation System (BAS) and Behavioural Inhibition System (BIS) result in behavioural inhibition/activation to rewards/punishments. Finally, State-Trait Anxiety Inventory (STAI-Y) and Back Depression Inventory (BDI-II) have been used to evaluate the potential comorbidity of anxiety and depression disorders. The results show that the FSS score was significantly higher in HD patients with high BIS Z-score than in HD patients with low and medium BIS Z-score. Conversely, the BDI score and the STAI-Y1 and STAI-Y2 scores were similar among BIS Z-score groups of HD patients. The correlation between BIS score and FSS score was statistically significant. These data suggest that there is a correlation between fatigue severity symptoms and motivational disposition mechanisms that predispose to action inhibition with possible consequences on patients’ engagement.
De Filippis, D., Bossola, M., Angioletti, L., Balconi, M., Fatigue and reward system in hemodialysis patients: integrating new methods and perspectives to assess chronic patients, Comunicazione, in Program of the "10th International Scientific Conference on Neuroethics and 5th Conference of the Italian Society for Neuroethics", (Milano, 16-18 May 2018), Società Italiana di Neuroetica, Milano 2018: N/A-N/A [http://hdl.handle.net/10807/119826]
Fatigue and reward system in hemodialysis patients: integrating new methods and perspectives to assess chronic patients
De Filippis, Daniela;Bossola, Maurizio;Angioletti, Laura;Balconi, Michela
2018
Abstract
Nowadays there is a growing interest in finding new interventions to face debilitating symptoms of patients on chronic conditions. Among these, fatigue is a common symptom experienced by patients affected by end-stage renal failure on chronic hemodialysis (HD) that significantly affects their quality of life (QoL). Recently, research on neuro-immune interactions has demonstrated that an alteration of the basal ganglia function, regulated by dopamine, may translate in a reduced motivation and altered reward processes in other chronic diseases, such as hemodialysis patients. Thus, the aim of this study was to investigate a possible correlation between the severity of fatigue and the reward mechanisms that regulate the motivational behaviours, and how these mechanisms are affected in HD patients with a significant impact on their QoL. Evaluative scales have been administered to a sample of haemodialysis patients (N=94) older than 18 years, with no neurocognitive disease. Fatigue Severity Scale (FSS) has been applied to measure the impact of fatigue on motivation and social functionality. BIS/BAS Scale has been administered to investigate the mechanisms of reward: Behavioural Activation System (BAS) and Behavioural Inhibition System (BIS) result in behavioural inhibition/activation to rewards/punishments. Finally, State-Trait Anxiety Inventory (STAI-Y) and Back Depression Inventory (BDI-II) have been used to evaluate the potential comorbidity of anxiety and depression disorders. The results show that the FSS score was significantly higher in HD patients with high BIS Z-score than in HD patients with low and medium BIS Z-score. Conversely, the BDI score and the STAI-Y1 and STAI-Y2 scores were similar among BIS Z-score groups of HD patients. The correlation between BIS score and FSS score was statistically significant. These data suggest that there is a correlation between fatigue severity symptoms and motivational disposition mechanisms that predispose to action inhibition with possible consequences on patients’ engagement.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.