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Physical and Mental Fatigue in Parkinson’s Disease

Epidemiology, Pathophysiology and Treatment

  • Therapy In Practice
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Abstract

Fatigue is one of the most common non-motor complaints of Parkinson’s disease (PD) patients and is associated with reduced activity and poorer quality of life. Fatigue can be experienced as a state of being tired or weary (subjective fatigue) or as a process of becoming tired or fatigued (fatigability). Subjective mental and physical fatigue are evaluated using self-report questionnaires such as the Multidimensional Fatigue Inventory. Physical fatigability is studied in a laboratory setting using physical exercise protocols and transcranial magnetic stimulation. Mental fatigability is evaluated by measuring attention over time using a reaction-time paradigm called the Attention Network Test (ANT).

PD patients report more subjective physical and mental fatigue than controls on a variety of fatigue questionnaires. PD patients have increased physical fatigability in force generation and finger tapping. Levodopa and modafinil improve physical fatigability in PD subjects. Methylphenidate is useful for treating subjective physical fatigue. PD subjects have greater mental fatigability than control subjects and display abnormal performance in all three attention networks in the ANT. Therapies targeting the neurotransmitter systems involved in attention may be helpful for treating mental fatigability.

Future fatigue research should focus on developing gold standards for fatigue measurement and developing treatments for fatigue and fatigability in PD.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The studies were supported by grants from the Medical Research Foundation (MRF) of Oregon, Parkinson’s Disease Foundation (PDF), National Parkinson Foundation (NPF), Michael J Fox Foundation (MJFF) for Parkinson’s Research, and National Institutes of Health (NIH). The author has no conflicts of interest that are directly relevant to the content of this review. The author would like to thank Grace Arnold for her technical editing.

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Correspondence to Jau-Shin Lou.

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Lou, JS. Physical and Mental Fatigue in Parkinson’s Disease. Drugs Aging 26, 195–208 (2009). https://doi.org/10.2165/00002512-200926030-00002

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