Enrica Olivola1,2, Livia Brusa3, Camilla Rocchi1, Orazio Schillaci2,4, Claudio Liguori1, Rocco Cerroni1, Mariangela Pierantozzi1, Agostino Chiaravalloti2,4, Alessandro Stefani5, Fabrizio Stocchi6. 1. UOSD Parkinson's Center, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. 2. IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy. 3. Ospedale S. Eugenio, ASL RMC, Rome, Italy. 4. Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. 5. UOSD Parkinson's Center, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. stefani@uniroma2.it. 6. Department of Neurology, Institute for Research and Medical Care, IRCCS San Raffaele, Rome, Italy.
Abstract
BACKGROUND: Despite its negative impact on quality of life, fatigue in Parkinson's disease (PD) remains an under-recognized issue and the underlying pathology is undetermined. OBJECTIVE: To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients. METHODS: In a Caucasian population of PD patients (n = 27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests. RESULTS: PFS-16 score correlated with disease duration (R = 0.57, p = 0.002). Fatigue showed a clear correlation with deep breathing test (R = - 0.53, p = 0.004) but not with the MIBG H/M ratios. CONCLUSIONS: Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.
BACKGROUND: Despite its negative impact on quality of life, fatigue in Parkinson's disease (PD) remains an under-recognized issue and the underlying pathology is undetermined. OBJECTIVE: To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PDpatients. METHODS: In a Caucasian population of PDpatients (n = 27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests. RESULTS: PFS-16 score correlated with disease duration (R = 0.57, p = 0.002). Fatigue showed a clear correlation with deep breathing test (R = - 0.53, p = 0.004) but not with the MIBG H/M ratios. CONCLUSIONS: Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.
Authors: Fabrizio Stocchi; Giovanni Abbruzzese; Roberto Ceravolo; Pietro Cortelli; Marco D'Amelio; Maria F De Pandis; Giovanni Fabbrini; Claudio Pacchetti; Gianni Pezzoli; Alessandro Tessitore; Margherita Canesi; Claudio Iannacone; Mario Zappia Journal: Neurology Date: 2014-06-13 Impact factor: 9.910
Authors: Christiana Ossig; Daniel Sippel; Mareike Fauser; Florin Gandor; Wolfgang H Jost; Georg Ebersbach; Alexander Storch Journal: J Parkinsons Dis Date: 2017 Impact factor: 5.568