Factors Affecting Interictal Fatigue In Adult Epilepsy Patients

Objective:To investigate the influencing factors of interictal fatigue in adult epilepsy patients in northeast China.Method: The present study was a cross-sectional observational study involving adults with epilepsy who were treated and followed up at the Epilepsy Clinic of Bethune First Hospital of Jilin University from April 2021 to July 2021.Patients with epilepsy were divided into fatigue and non-fatigue groups based on fatigue severity Scale（FSS）scores at the time of inclusion.Demographic,sociological,epilepsy related clinical characteristics,emotional factors and sleep factors were collected.Pittsburgh Sleep Quality Index（PSQI）,Epworth Sleepiness Scale（Epworth Sleepiness Scale）,National Hospital Attack Severity Scale（NHS3）,Chinese Version of Neurological Disorders with Depression Scale（CNDDI-E）,Generalized Anxiety Disorder Scale（GAD-7）,and quality of life of epilepsy patients were used The 31-item scale（QOLIE-31）.The correlative factors and independent predictors of fatigue were determined by comparative analysis,correlation analysis and binary stepwise Logistic regression analysis.Result: Among 179 adult patients with epilepsy included in this study,there were 93 males and 86 females,Patients ranged in age from 18 to 67 years,with a median age of 32 years.According to FSS scores,46 patients had fatigue and 133 did not.By comparison between groups,the older the patients（P=0.015）,the longer the course of disease（P=0.033）,> 90% of the onset in sleep（P=0.044）,PSQI score（P < 0.001）,Epworth score（P<0.001）,NHS3 score（P<0.001）,cNDDI-E score（P<0.001）,GAD-7 score（P<0.001）,QOLIE-31 score（P<0.001）were associated with increased fatigue.Correlation analysis showed that interictic period,age（P=0.015）,course of disease（P=0.032）,PSQI score（P < 0.001）,Epworth score（P < 0.001）,NHS3 score（P <0.001）,cNDDI-E score（P<0.001）and GAD-7 score（P<0.001）were positively correlated with fatigue level in adult epilepsy patients,while QOLIE-31 score（P < 0.001）and sleep attack（P=0.044）were negatively correlated with fatigue level.Dichotomous stepwise Logistic regression analysis revealed that age（OR=1.043;P=0.023;95%CI :1.006-1.081）,Epworth score（OR=1.135;P=0.004;95%CI:1.041-1.294）,cNDDI-E score（OR=1.201;P=0.014;95%CI : 1.038-1.389）and QOLIE-31 score（OR=0.944;P=0.045;99%CI:0.893-0.999）were independent predictors of interictal fatigue in adult epilepsy patients.Conclusion:In adult epilepsy patients,interictic period,age,course of disease,PSQI scale score,Epworth score,NHS3 score,cNDDI-E score and GAD-7 score were positively correlated with fatigue level,while QOLIE-31 score and sleep attack were negatively correlated with fatigue level.Meanwhile,age,Epworth score,cNDDI-E score and QOLIE-31 scale score were independent predictors of interictic fatigue in adult epilepsy patients.