Fatigue in early Parkinson's disease. Minor inconvenience or major distress?
Fatigue in early Parkinson's disease. Minor inconvenience or major distress?
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DOI：
10.1111/j.1468-1331.2012.03663.x
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发表时间：
2012-07-01
影响因子：
5.1
通讯作者：
Larsen, J. P.
中科院分区：
文献类型：
--
作者：
Herlofson, K.;Ongre, S. O.;Larsen, J. P.
背景和目的：虽然疲劳被认为是帕金森氏病(PD)患者常见的、使人虚弱的症状，但对于这种症状是如何以及何时出现在疾病进展过程中的，人们知之甚少。这项研究的目的是探讨帕金森病患者在诊断时，在多巴胺能治疗之前，疲劳的存在和严重程度。方法：本研究是挪威帕克韦斯特项目的一部分，该项目是对挪威帕金森病患者的大型队列研究。帕金森病按Gelb标准诊断。研究人群包括199名未经治疗的新诊断PD患者和172名对照受试者，性别和年龄匹配。采用疲劳严重度量表(FSS)测量疲劳程度。结果：55%的PD患者有明显的临床疲劳(FSS>；4)，而对照组的这一比例约为20%(RR=2.9)。FSS患者的平均得分为4.4(SD 1.7)，对照组为3.1(SD 1.3)。此外，在9个FSS项目中，患者和对照组之间的每一项都有非常显著的差异。在回归分析中，只有蒙哥马利和安格斯特罗姆抑郁评定量表和统一帕金森病评定量表-日常生活能力评分与疲劳显著相关。疲劳、认知功能障碍和嗜睡之间无相关性。结论：疲劳是帕金森病患者的常见症状，也是早期未经治疗的疾病患者的常见症状，对患者的日常生活活动能力有负面影响。在早期帕金森病患者的治疗中，疲劳也是一个重要的考虑因素。
Background and purpose: Although fatigue is recognized as a common and debilitating symptom in patients with Parkinsons disease (PD), little is known on how and when this symptom emerges during disease progression. The aim of the study was to explore the presence and severity of fatigue in patients with PD at the time of diagnosis, before dopaminergic treatment has been instituted. Methods: The present study is part of the Norwegian ParkWest project, a large cohort study of patients with incident PD in Norway. PD was diagnosed according to the Gelb criteria. The study population comprised 199 patients with untreated, newly diagnosed PD and 172 control subjects, matched for gender and age. Fatigue was measured by the Fatigue Severity Scale (FSS). Results: Fifty-five percent of the patients with PD had clinical significant fatigue (FSS > 4), compared with about 20% of the controls (RR = 2.9). The mean score in patients on the FSS was 4.4 (SD 1.7) and in controls 3.1 (SD 1.3). In addition, there were highly significant differences between patients and controls in each of the nine FSS items. In a regression analysis, only the Montgomery and angstrom sberg Depression Rating Scale and Unified Parkinsons Disease Rating Scale-Activities of Daily Living scores were significantly associated with fatigue. There was no correlation between fatigue and cognitive impairment and hypersomnia. Conclusion: Fatigue is a common symptom in PD, also in patients with early, untreated disease, and it has a negative impact on these patients activity of daily living. Also in early PD, fatigue is an important consideration in the management of patients with the disease.