correlates Prevalence of fatigue in Parkinson disease and its clinical

Objective: To assess in a noninterventional setting the prevalence and severity of fatigue in patients with Parkinson disease (PD). Methods: This was a cross-sectional study conducted in Italian patients with PD. Objectives included the evaluation of the current prevalence and severity of fatigue in patients with PD measured using the 16-item Parkinson Fatigue Scale (PFS-16), distressing fatigue (defined as a PFS-16 mean score $3.3), and assessment of its clinical correlates. Results: A total of 402 patients were enrolled and 394 patients completed the PFS-16 questionnaire with a PFS-16 mean (6SD) score of 2.876 0.99. Of these, 136 patients (33.8%) reported distressing fatigue (PFS-16 mean score $3.3). Patients with distressing fatigue were older (p 5 0.044) and had a longer duration of PD (p , 0.0001) than those without distressing fatigue. The presence of distressing fatigue was associated with higher total Unified Parkinson’s Disease Rating Scale (UPDRS) scores, poorer quality of life (39-item Parkinson’s Disease Questionnaire [PDQ-39]), worse social and psychological behaviors, a higher severity of depressive symptoms, and a higher prevalence of sleep disorders (all p , 0.001). Logistic regression analyses revealed that higher total UPDRS scores, female sex, depression, sleep disorders, as well as higher UPDRS activities of daily living scores and PDQ-39 mobility scores increase the likelihood of distressing fatigue in patients with PD. Conclusions: Approximately one-third of patients with PD have distressing fatigue, which is significantly associated with depression and sleep disorders. The fact that the presence of fatigue worsens patient quality of life supports the need to better diagnose and treat this debilitating symptom. Neurology® 2014;83:1–6 GLOSSARY DSM-IV 5 Diagnostic and Statistical Manual of Mental Disorders, 4th edition; ICD-10 5 International Classification of Diseases, 10th revision; MAO-B 5 monoamine oxidase B; MS 5 multiple sclerosis; PD 5 Parkinson disease; PDQ-39 5 39-item Parkinson’s Disease Questionnaire; PDSS5 Parkinson’s Disease Sleep Scale; PFS-165 16-item Parkinson Fatigue Scale; UPDRS 5 Unified Parkinson’s Disease Rating Scale. Fatigue is a nonspecific symptom common to several CNS disorders. According to ICD-10, signs and symptoms of fatigue include asthenia, debility, general physical deterioration, lethargy, and tiredness. Although previously overlooked in Parkinson disease (PD), fatigue is now accepted to be one of the most common PD symptoms with a reported prevalence between 33% and 58%. Not only is the prevalence of fatigue higher than the age-matched population, the fatigue experienced in PD seems to be qualitatively different from that experienced by the general population. Fatigue is often considered by patients with PD to be one of the most disabling symptoms affecting daily activities and quality of life. From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson’s Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy. FORTE Study Group coinvestigators are listed on the Neurology® Web site at Neurology.org. Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. © 2014 American Academy of Neurology 1 a 2014 American Academy of Neurology. Unauthorized reproduction of this article is prohibited. Published Ahead of Print on June 13, 2014 as 10.1212/WNL.0000000000000587