The Dysfunctional Autonomic Function and "Dysfunctional" Fatigue in Drug Naïve Parkinson's Disease.
J Parkinsons Dis
; 10(2): 605-612, 2020.
Article
em En
| MEDLINE
| ID: mdl-32250319
ABSTRACT
BACKGROUND:
Fatigue is a common and disabling non-motor symptom in Parkinson's disease (PD). Autonomic dysfunction is suggested as the possible pathophysiology of fatigue, but it has not been investigated in drug-naïve PD patients.OBJECTIVE:
In the present study, the relationship between fatigue and autonomic dysfunction in drug-naïve PD patients was investigated.METHODS:
In the present study, 89 drug-naïve PD patients were analyzed. The Parkinson's disease fatigue scale (PFS) was used to divide the patients into fatigue (mean PFS≥3.3) and non-fatigue groups (mean PFSâ<â3.3). The autonomic function test (AFT), Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), Unified Parkinson's Disease Rating Scale (UPDRS)-I, -II, -III, modified Hoehn and Yahr (H&Y) scale, Montreal Cognitive Assessment (MoCA), Parkinson's Disease Questionnaire-39 (PDQ-39), Parkinson's Disease Sleep Scale (PDSS), and Beck Depress Index (BDI) were performed in all the participants. The AFT results and clinical scales were compared using multiple logistic regression analysis.RESULTS:
The prevalence of fatigue was 23.6% (nâ=â21) in drug-naïve PD patients. Total SCOPA-AUT score was higher in the fatigue group than in the non-fatigue group. The fatigue group had lower inspiratoryexpiratory (IE) ratio and Valsalva ratio. The prevalence of abnormal sympathetic skin response and orthostatic hypotension (OH) was 19% and 38.1%, respectively, in the fatigue group. Regression model analysis revealed that SCOPA-AUT and OH were the most related factor of fatigue in drug-naïve PD patients.CONCLUSION:
Autonomic dysfunction in drug-naïve PD patients was investigated using a subjective scale as well as objective tests. The results indicated that fatigue is associated with autonomic dysfunction, especially OH, in drug-naïve PD patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Doenças do Sistema Nervoso Autônomo
/
Fadiga
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Parkinsons Dis
Ano de publicação:
2020
Tipo de documento:
Article