Motor,behavioural, and cognitive correlates of fatigue in early,de novo Parkinson disease patients |
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| Affiliation: | 1. Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, MRI Research Center SUN-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138, Naples, Italy;2. Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico 31, 81100, Caserta, Italy;3. ICS Maugeri, Scientific Institute of Telese, Via Bagni Vecchi 2, 82037, Telese, Italy;4. IDC-Hermitage-Capodimonte, Via Cupa Delle Tozzole 2, 80131, Naples, Italy;1. Institute of Neurology CCS, School of Medicine, University of Belgrade, Belgrade, Serbia;2. Clinic for Neurology and Psychiatry for Children and Youth, School of Medicine, University of Belgrade, Belgrade, Serbia;3. Institute of Neurogenetics, University of Lübeck, Lübeck, Germany;4. Institute for Human Genetics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia;1. Institute of Molecular and Clinical Sciences, St George''s University of London, London, United Kingdom;2. Institute of Cognitive Neuroscience, UCL, London, United Kingdom;3. Aging Research Center, Karolinska Institute, Stockholm, Sweden;4. Department of Clinical and Experimental Medicine, University of Messina, Italy;5. Department of Neurology, Otto-von-Guericke University Hospital Magdeburg, Germany;1. Department of Neuroscience, Center for Movement Disorders and Neurorestoration, 3450 Hull Road, University of Florida, Gainesville, FL 32607, United States;2. Department of Neurology, Center for Movement Disorders and Neurorestoration, 3450 Hull Road, University of Florida, Gainesville, FL 32607, United States;3. Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States;4. Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, 3rd Floor, University of Florida, Gainesville, FL 32611, United States;5. J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States;1. Institute of Clinical Medicine, Department of Neurology, University of Oulu, Oulu, Finland;2. Department of Neurology and Medical Research Center, Oulu University Hospital, Oulu, Finland;3. Laboratory for Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA;4. Institute of Clinical Medicine, Department of Neurology, University of Turku, Turku, Finland;5. Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland;6. Neuro Center, Kuopio University Hospital, Kuopio, Finland;7. Department of Neurology, Helsinki University Hospital, Research Programs Unit, Molecular Neurology, Biomedicum, University of Helsinki, Helsinki FIN-02900, Finland;8. Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland |
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| Abstract: | IntroductionFatigue is one of the most common and disabling non-motor symptoms in Parkinson's disease (PD). The objective of this study was to determine prevalence and motor, behavioural, and cognitive correlates of distressing fatigue in early, de novo PD patients.MethodsEighty-one consecutive de novo PD patients (64% men; mean age 65.73 ± 8.26 years) underwent a comprehensive examination, including Parkinson's disease Fatigue Scale (PFS), Epworth Sleepiness Scale (ESS), Parkinson's Disease Sleep Scale (PDSS), Beck Depression Inventory (BDI), Parkinson's Anxiety Scale (PAS), and Apathy Evaluation Scale (AES). Moreover, all patients underwent a detailed neuropsychological evaluation exploring attention and working memory, executive functions, memory, visuospatial abilities and language. Score of patients with or without distressing fatigue (defined as a PFS score ≥ 8) were compared by Student's t-test or Pearson's chi-square test. Logistic regression analyses were performed to search for motor and non-motor features independently associated with presence of distressing fatigue.ResultsTwelve (15%) patients presented distressing fatigue. Logistic regression identified sleepiness (p = 0.04), “episodic anxiety” subscale of PAS (p = 0.005), and “cognitive apathy” subscale of AES (p = 0.017) as the main factors associated with distressing fatigue. No significant association was found between diagnosis of Mild Cognitive Impairment and distressing fatigue (p = 0.745).ConclusionIn a sample of consecutive de novo PD patients, distressing fatigue is associated with episodic anxiety, cognitive apathy and sleepiness, but not with cognitive impairment. Our findings suggest possible shared pathogenic mechanisms underlying these non-motor symptoms and foster development of early combined therapeutic approaches. |
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| Keywords: | Fatigue Behavioural Cognition Mild cognitive impairment PD Non-motor symptoms Motor symptoms |
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