Clinical Characteristics Of Fatigue And Its Related Factors In Patients With Parkinson's Disease

Objective To investigate the characteristics and the related factors of fatigue in Parkinson's disease(PD)patients.Methods The demographic and clinical information of 91 patients with idiopathic PD consulting in the outpatient department of the first affiliated hospital,Anhui Medical University were collected.The fatigue severity scale(FSS)and multidimensional fatigue scale(MFI-20)were used to evaluate the fatigue symptoms of PD patients.All patients were assessed with Unified Parkinson's Disease Rating Scale(UPDRS),Hoehn-Yahr(HY)stage,Mini-mental State Examination(MMSE),Hamilton anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD),Pittsburgh Sleeping Quality Index(PSQI),and Epworth Sleepiness Scale(ESS).The participants were divided into fatigue group and non-fatigue group according to FSS,the related factors were compared between the two group and the risk factors of fatigue were analyzed by Logistic regression.The correlation between two MFI-20 dimensions(mental fatigue and physical fatigue)were analyzed and the related factors for each dimension were assessed by multiple linear regression.Results According to the results of FSS,47 of 91 PD patients suffered from fatigue(FSS score> 4),the incidence of fatigue was 56.4%.There were no significant differences between fatigue group(FSS > 4)and non-fatigue group(FSS ? 4)in gender,age and educational level(P> 0.05).The disease duration,scores of H-Y,Levodopa Equivalent Dose(LED),UPDRSI-IV,HAMA,PSQI and ESS in fatigue group were higher than those in non-fatigue group.Logistic regression analysis showed that the scores of ESS and UPDRS ?were independent risk factors for the scores of FSS.Correlation analysis showed that there was no correlation between physical fatigue score and mental fatigue score.Multiple linear regression analysis showed that physical fatigue score was related with H-Y stage,mental fatigue score was significantly associated with HAMA and HAMD.Conclusion PD patients have high incidence of fatigue which is associated with a variety of motor and non-motor symptoms.Physical fatigue and mental fatigue are independent symptoms of Parkinson's disease.The associated factors of the two fatigue subtypes are different,physical fatigue is mainly related to the severity of motor symptoms,while mental fatigue is more affected by emotional factors.Management for PD patients with fatigue should be individualized according to the specific fatigue subtypes and influencing factors.