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Frequency, course and predictors of fatigue in Parkinson’s disease patients and population-based controls

E. Warrlich, EJ. Vollstedt, R. Modreanu, B. Hauptmann, V. Tadic, S. Tunc, C. Kritzinger, J. Prasuhn, A. Balck, M. Borsche, H. Hanssen, N. Brüggemann, C. Klein, M. Kasten (Luebeck, Germany)

Meeting: 2019 International Congress

Abstract Number: 1642

Keywords: Non-motor Scales, Parkinsonism

Session Information

Date: Wednesday, September 25, 2019

Session Title: Non-Motor Symptoms

Session Time: 1:15pm-2:45pm

Location: Agora 3 West, Level 3

Objective: To assess fatigue frequency, course, and predictors in a large and diverse cohort of Parkinson’s disease (PD) patients and controls.

Background: Fatigue is a frequent and disabling symptom in Parkinson’s disease (PD). It may precede motor signs and thus can be useful for earlier diagnosis. Knowledge on the course of fatigue is scarce, as are the means to address it therapeutically.

Method: We examined a cohort of 1030 participants, including PD patients recruited in our movement disorders clinic and controls recruited via population screening. Controls were unselected non-PD persons who could have other disorders including motor impairment to address the specificity of fatigue. The MDS-UPDRS item on fatigue was assessed over the course of 2 years in healthy controls (n=278), disease controls (n=242), persons with mild parkinsonian signs (n=72), and PD (n=435).

Results: In PD patients, the frequency of fatigue was 31% and it was similar for disease controls (26%), whereas healthy controls (13%) and persons with mild parkinsonian signs (14%) reported fatigue at lower frequencies. We observed comparable frequencies among men and women. Over a two-year course, fatigue persisted in 49% and out of all persons with fatigue, 64% reported improved, 20% worsened severity. Across groups, the postural instability gait disorder score was associated with fatigue, as were depressive and anxiety symptoms, daytime sleepiness, and certain medications. Comparing the baseline and follow-up examinations, previous fatigue was associated with current fatigue.

Conclusion: Fatigue is common, persistent and difficult to treat. However, the frequency in PD patients and disease controls was similar and we did not observe an increased frequency of fatigue in persons with mild parkinsonian signs in our sample, calling for additional information to successfully use fatigue as premotor marker. Indirect measures to alleviate fatigue, such as treating possible predictors, e.g. depression, may help persons suffering from fatigue.

To cite this abstract in AMA style:

E. Warrlich, EJ. Vollstedt, R. Modreanu, B. Hauptmann, V. Tadic, S. Tunc, C. Kritzinger, J. Prasuhn, A. Balck, M. Borsche, H. Hanssen, N. Brüggemann, C. Klein, M. Kasten. Frequency, course and predictors of fatigue in Parkinson’s disease patients and population-based controls [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/frequency-course-and-predictors-of-fatigue-in-parkinsons-disease-patients-and-population-based-controls/. Accessed June 14, 2025.
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