S O Ongre1,2, I Dalen3, O-B Tysnes4, G Alves5,6, K Herlofson2. 1. Department of Neurology, Sorlandet Hospital, Kristiansand, Norway. 2. Department of Research, Sorlandet Hospital, Kristiansand, Norway. 3. Department of Research, Section for Biostatistics, Stavanger University Hospital, Stavanger, Norway. 4. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 5. Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. 6. Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway.
Abstract
BACKGROUND AND PURPOSE: Although highly disabling, the pathogenesis and evolution of fatigue in Parkinson's disease (PD) is largely unknown, and no sufficiently documented treatment currently exists. The aim of the present study was to investigate the evolution of fatigue during the first 9 years after diagnosis. METHODS: This study is part of the Norwegian ParkWest collaboration, a prospective population-based longitudinal cohort study. The present study comprised 191 newly diagnosed patients and 170 control participants. Fatigue was assessed by the Fatigue Severity Scale, with examinations at baseline and then every other year up to 9 years of follow-up. Linear mixed models were applied to investigate possible variables associated with fatigue. RESULTS: It was found that there was a statistically significant increase in the proportion of PD patients with fatigue during the first 9 years after diagnosis. A large proportion of patients had a significant increase or decrease in fatigue score between consecutive visits. In addition, the relative risk of persistent fatigue and ever having fatigue was higher than for controls. There were statistically significant longitudinal associations between higher levels of fatigue and female gender, comorbidity at baseline, depressive symptoms, dependency in activities of daily living and better cognitive functioning. Lower levels of fatigue were associated with the use of dopamine agonists. CONCLUSION: Fatigue is a common, severely limiting symptom in PD. This study demonstrates associations with other factors that could yield a better understanding of the symptom and thus possible treatment strategies, although further investigations are necessary to establish causal relationships.
BACKGROUND AND PURPOSE: Although highly disabling, the pathogenesis and evolution of fatigue in Parkinson's disease (PD) is largely unknown, and no sufficiently documented treatment currently exists. The aim of the present study was to investigate the evolution of fatigue during the first 9 years after diagnosis. METHODS: This study is part of the Norwegian ParkWest collaboration, a prospective population-based longitudinal cohort study. The present study comprised 191 newly diagnosed patients and 170 control participants. Fatigue was assessed by the Fatigue Severity Scale, with examinations at baseline and then every other year up to 9 years of follow-up. Linear mixed models were applied to investigate possible variables associated with fatigue. RESULTS: It was found that there was a statistically significant increase in the proportion of PDpatients with fatigue during the first 9 years after diagnosis. A large proportion of patients had a significant increase or decrease in fatigue score between consecutive visits. In addition, the relative risk of persistent fatigue and ever having fatigue was higher than for controls. There were statistically significant longitudinal associations between higher levels of fatigue and female gender, comorbidity at baseline, depressive symptoms, dependency in activities of daily living and better cognitive functioning. Lower levels of fatigue were associated with the use of dopamine agonists. CONCLUSION:Fatigue is a common, severely limiting symptom in PD. This study demonstrates associations with other factors that could yield a better understanding of the symptom and thus possible treatment strategies, although further investigations are necessary to establish causal relationships.
Authors: Diego Santos-García; Teresa de Deus; Carlos Cores; Hector Canfield; Jose M Paz González; Cristina Martínez Miró; Lorena Valdés Aymerich; Ester Suárez; Silvia Jesús; Miquel Aguilar; Pau Pastor; Lluis Planellas; Marina Cosgaya; Juan García Caldentey; Nuria Caballol; Ines Legarda; Jorge Hernández-Vara; Iria Cabo; Lydia López Manzanares; Isabel González Aramburu; Maria A Ávila Rivera; Maria J Catalán; Victor Nogueira; Victor Puente; Julio Dotor; Carmen Borrué; Berta Solano; Maria Álvarez Sauco; Lydia Vela; Sonia Escalante; Esther Cubo; Francisco Carrillo; Juan C Martínez Castrillo; Pilar Sánchez Alonso; Gemma Alonso; Nuria López Ariztegui; Itziar Gastón; Jaime Kulisevsky; Marta Blázquez; Manuel Seijo; Javier Rúiz Martínez; Caridad Valero; Monica Kurtis; Oriol de Fábregues; Jessica Ardura; Ruben Alonso; Carlos Ordás; Luis M López Díaz; Darrian McAfee; Pablo Martinez-Martin; Pablo Mir Journal: J Pers Med Date: 2021-06-30