Is fatigue an independent and persistent symptom in patients with Parkinson disease?
Is fatigue an independent and persistent symptom in patients with Parkinson disease?
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DOI：
10.1212/01.wnl.0000144277.06917.cc
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发表时间：
2004-11-23
期刊：
影响因子：
9.9
通讯作者：
Larssen, JP
中科院分区：
文献类型：
--
作者：
Alves, G;Wentzel-Larsen, T;Larssen, JP
目的：评估精神疲劳是否是帕金森病（PD）患者独立于其他临床特征而出现的症状，并研究这些患者的疲劳是否长期持续。方法：1993年，233例PD患者被纳入一项基于社区的疲劳研究，并随访8年以上。在基线和4年和8年后，通过7分制和部分诺丁汉健康概况（NHP）的组合来测量疲劳。此外，2001年还采用了疲劳严重程度量表（FSS）进行疲劳评价。对相关数据进行人口平均logistic回归模型，研究疲劳与各种人口统计学和临床变量之间的关系。结果：在8年的随访期间，患者的疲劳程度从1993年的35.7%上升到1997年的42.9%和2001年的55.7%。疲劳与疾病进展、抑郁和白天过度嗜睡（EDS）有关。然而，在没有抑郁和EDS的患者中，疲劳的患病率仍然很高，在研究期间从32.1%增加到38.9%。在研究期间，约44%的疲劳患者的症状有所不同，56%的疲劳患者的症状持续存在。结论：作者证实了帕金森病（PD）患者精神疲劳的高患病率。疲劳与其他非运动特征有关，如抑郁和白天过度嗜睡，但不能单独用这种合并症来解释。在超过一半的患者中，精神疲劳是持续的，似乎是与PD的进行性神经退行性疾病平行发展的独立症状。
Objective: To evaluate if mental fatigue is a symptom that appears independently from other clinical features in patients with Parkinson disease (PD), and to study if fatigue is persistent over time in these patients. Methods: In 1993, 233 patients with PD were included in a community-based study of fatigue and followed prospectively over 8 years. Fatigue was measured by a combination of a seven-point scale and parts of the Nottingham Health Profile (NHP) at baseline and after 4 and 8 years. In addition, the Fatigue Severity Scale (FSS) was used to evaluate fatigue in 2001. Population-averaged logistic regression models for correlated data were performed to study the relationship between fatigue and various demographic and clinical variables. Results: In patients who were followed throughout the 8-year study period, fatigue increased from 35.7% in 1993 to 42.9% in 1997 and 55.7% in 2001. Fatigue was related to disease progression, depression, and excessive daytime sleepiness (EDS). However, the prevalence of fatigue in patients without depression and EDS remained high and increased from 32.1% to 38.9% during the study period. For about 44% of the patients with fatigue the presence of this symptom varied during the study period, as it was persistent in 56% of the patients with fatigue. Conclusions: The authors confirmed the high prevalence of mental fatigue in patients with Parkinson disease ( PD). Fatigue is related to other non-motor features such as depression and excessive daytime sleepiness, but cannot be explained by this comorbidity alone. In more than half of the patients mental fatigue is persistent and seems to be an independent symptom that develops parallel to the progressive neurodegenerative disorder of PD.