Eur J Neurol. 2012 Feb 16. doi: 10.1111/j.1468-1331.2012.03663.x. [Epub ahead of print]
Herlofson K, Ongre SO, Enger LK, Tysnes OB, Larsen JP.
Source
Department
of Neurology, Sorlandet Hospital, Arendal Department of Neurology,
Haukeland University Hospital, Bergen Department of Neurology,
Stavanger University Hospital and the Norwegian Centre for Movement
Disorders, Stavanger University Hospital, Stavanger, Norway.
Abstract
Background
and purpose: Although fatigue is recognized as a common and
debilitating symptom in patients with Parkinson's disease (PD), little
is known on how and when this symptom emerges during disease
progression. The aim of the study was to explore the presence and
severity of fatigue in patients with PD at the time of diagnosis,
before dopaminergic treatment has been instituted. Methods: The
present study is part of the Norwegian ParkWest project, a large cohort
study of patients with incident PD in Norway. PD was diagnosed
according to the Gelb criteria. The study population comprised 199
patients with untreated, newly diagnosed PD and 172 control subjects,
matched for gender and age. Fatigue was measured by the Fatigue
Severity Scale (FSS). Results: Fifty-five percent of the patients with
PD had clinical significant fatigue (FSS > 4), compared with about
20% of the controls (RR = 2.9). The mean score in patients on the FSS
was 4.4 (SD 1.7) and in controls 3.1 (SD 1.3). In addition, there were
highly significant differences between patients and controls in each of
the nine FSS items. In a regression analysis, only the Montgomery and
Åsberg Depression Rating Scale and Unified Parkinson's Disease Rating
Scale-Activities of Daily Living scores were significantly associated
with fatigue. There was no correlation between fatigue and cognitive
impairment and hypersomnia. Conclusion: Fatigue is a common symptom in
PD, also in patients with early, untreated disease, and it has a
negative impact on these patients' activity of daily living. Also in
early PD, fatigue is an important consideration in the management of
patients with the disease.
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