Retrospective Analysis The Related Factors Of Fatigue In Parkinson's Disease

Object Parkinson's disease(PD)is a common degenerative disease of the middle-aged and elderly patients in neurology.The fatigue as one of the non-motor symptoms has seriously impacted on the treatment and reduced the effectiveness of treatment.The aim of the study was to analyze retrospectively the related clinical factors of fatigue in PD.Methods Dates collected from November 2015 to January 2017 visited in department of neurology in the First Hospital of Dalian Medical University.PD was diagnosed according to the United Kingdom(UK)Brain Bank diagnostic criteria for PD before May 2016,according to the 2016 Chinese PD diagnostic criteria after May 2016.The two methods were used to assess fatigue,Used the Fatigue Severity Scale(FSS)and PD Fatigue Scale(PFS),the fatigue group: the mean score?4points,the non-fatigue group: the mean score<4points;the fatigue group:the mean score?3.3points;the non-fatigue group: the mean score<3.3 points.Analysis the correlation of the fatigue and demographic data,motor symptoms,the non-motor symptoms(NMS),the quality of life.All scales assessmented in "on" of patients.(1)Demographic date Gender,age,age of onset,the course of the disease,education level(1.primary school and below 2.the junior middle school and senior high school3.university and above).(2)Motor symptoms Evaluated motor symptoms by Unified Parkinson's Disease Rating Scale III(UPDRS III),Hoehn-Yahr stages(H-Y stages),the types of clinical symptoms(tremor,myotonia),onset side(the left side of the onset,the right side of onset).(3)Non-motor symptoms(NMS)Evaluated NMS by Non-Motor Symptoms Questionnaire(NMS Quest),Montreal Cognitive Assessment(Mo CA),Mini-Mental State Examination(MMSE),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Modified Apathy Evaluation Scale(MAES),Pittsburgh Sleep Quality Index(PSQI),The Scale For Outcomes in PD For Autonomic Symptoms(SCOPA-AUT),evaluated mental behavior by Unified Parkinson's Disease Rating Scale I(UPDRS I).(4)The relationship between fatigue and quality of life in PD patients Used the39-item Parkinson's Disease Questionnaire(PDQL – 39)to evaluated the quality of life.Results The fatigued patients evaluated by FSS are 50(53.8%),by PFS are 47(50.5%)in 93 PD patients.Fatigue assessed by both FSS and PFS has a good consistency.FSS and PFS all used for distinguish the fatigue group and the non-fatigue group,there was no significant differences between fatigue and age,sex,age,age of onset,the course of the disease,the education level(P>0.05).There was no significant differences between fatigue and onset side,the types of clinical symptoms(p>0.05).There was no significant differences between fatigue and anxiety,depression,cognitive dysfunction,sleep(p>0.05).There was a significant differences between fatigue and UPDRS-III score,H-Y stages,the number of non-motor symptoms,apathy,autonomic symptoms(p<0.05).After correlation analysis about clinical factors of fatigue,there was a significant correlations between fatigue assessed by the two scales and UPDRSIII score(FSS:r =0.509,P =0.000,PFS:r =0.407,P = 0.000),H-Y stages(FSS:r =0.273,P =0.008,PFS:r=0.225,P=0.030),the number of non-motor Symptoms(FSS:r=0.543,P=0.000,PFS:r=0.483,P=0.000),apathy(FSS:r=0.430,P=0.000,PFS:r=0.453,P=0.000),autonomic symptoms(FSS:r=0.626,P=0.000,PFS:r=0.657,P=0.000),the quality of life(FSS:r=-0.558,P=0.000,PFS:r=-0.523,P=0.000).There was a positive relation between fatigue and UPDRS-III score,H-Y stages,the number of non-motor symptoms,apathy,autonomic disfunction.There was a negatively relation between fatigue and quality of life.Conclusions(1)The frequency of fatigue in PD was 50.5%-50.5%;(2)The higher scores of UPDRSIII and H-Y stage are prone to fatigue;(3)Autonomic disfunction was serious in PD patients with fatigue;(4)There was no significant correlations between fatigue and depression,anxiety.Fatigue was significantly associated with apathy;(5)The number of non–motor symptoms was significantly associated with fatigue in PD patients;(6)Fatigue affects the quality of life in PD significantly.