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Dr. Okun

New Study: Fatigue in PD

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Dear NPF forum members,


Fatigue in Parkinson's disease has become a topic of great interest as so many of our patients are affected. We always suspect sleep disorders (and frequently order sleep studies), mood disorders, and other causes although in many patients we can't pin down a cause or treatment. Here is an interesting study from Brazil looking at this issue. We need more and larger studies on the issue of fatigue in PD.


Braz J Med Biol Res. 2009 Aug;42(8):771-5. Links

Fatigue in a cohort of geriatric patients with and without Parkinson's disease.


Goulart FO, Godke BA, Borges V, Azevedo-Silva SM, Mendes MF, Cendoroglo MS, Ferraz HB.

Setor de Transtornos do Movimento, Departamento de Neurologia, Universidade Federal de São Paulo.

We evaluated the frequency of fatigue in geriatric patients with and without Parkinson's disease (PD) and correlated it with depression and excessive daytime sleepiness. We evaluated 100 patients from Hospital São Paulo, 50 with PD from the Neurologic Outpatient Clinic and 50 with non-neurologic diseases or oncologic diseases from the Geriatric Outpatient Clinic (controls). All patients who scored 28 or more on the Fatigue Severity Scale (FSS) were considered to have fatigue. Also, all patients were submitted to a structured interview to diagnose depression by the criteria of the American Psychiatric Association (DSM-IV, 4th version) and were evaluated by the Modified Impact of Fatigue Scale and the Epworth Sleepiness Scale (ESE) to detect excessive daytime sleepiness. Demographic and disease details of all PD patients were recorded and the patients were examined and rated by the Unified Parkinson's Disease Rating Sale (UPDRS) and Hoehn-Yahr staging. Frequency of fatigue (FSS >/=28) was 70% for PD and 22% for controls. Twenty of 35 PD patients with fatigue had concomitant depression. Compared to controls, PD patients were found more frequently to have depression by DSM-IV criteria (44 vs 8%, respectively) and excessive daytime sleepiness by the ESE (44 vs 16%), although only depression was associated with fatigue. Fatigue was more frequent among depressed PD and control patients and was not correlated with PD duration or with UPDRS motor scores. ESE scores did not differ between patients with or without fatigue.

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