Objective: The aim of this study was to investigate whether fatigue in idiopathic Parkinson’s disease is primary or secondary and to explore its correlation with various motor and non-motor scales.

Background: Fatigue is a prevalent and debilitating non-motor symptom in Parkinson’s disease (PD), often manifesting even in the premotor stages and persisting or worsening over time. Despite its significant impact on patients’ quality of life, the underlying mechanisms of fatigue in PD remain unclear.

Method: A case-control study was conducted on 50 patients with Parkinson’s disease attending the movement disorders outpatient clinic at Ain Shams University Hospital, along with 50 control subjects who were relatives or accompanying persons of the patients. All patients were subjected to detailed history and MRI brain. Diagnosis was based on the MDS 2015 criteria combined with UK brain bank criteria. The assessment tools included the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Non-Motor Symptoms Questionnaire (PD NMS), Parkinson’s Disease Fatigue Scale, Pittsburgh Sleep Quality Index, REM Sleep Behavior Disorder Scale, Restless Legs Syndrome Scale, Beck Depression Inventory (BDI), and Parkinson’s Anxiety Scale. Statistical analysis was performed using SPSS 22.

Results: The study showed a significantly higher fatigue score in the PD group (11.24 ± 4.67) compared to controls (7.14 ± 3.01) (p = 0.000). There was a significant correlation between the fatigue scale and levodopa equivalent dose (815.12 ± 435.48 mg, p = 0.000), UPDRS part III (41.49 ± 19.28, p = 0.012), UPDRS part IV (9.24 ± 4.45, p = 0.000), and Pittsburgh Sleep Quality Index (5.95 ± 2.40, p = 0.004). A moderate correlation was also found with the Beck Depression Inventory (21.23 ± 10.84, p = 0.008). However, there was no significant correlation with anxiety (p = 0.573), REM sleep behavior disorder (p = 0.182), or restless leg syndrome (p = 0.154).

Conclusion: Fatigue is a major issue affecting approximately half of the PD population, often developing early and persisting over time. It appears to be relatively independent of motor severity and other comorbidities, except for sleep quality and depression. Further research is needed to understand the underlying mechanisms and develop targeted therapeutic interventions.

Comparison Between Control and Case Groups

Comparison Regarding Motor scales

Comparison Regarding Non-Motor Scales

Comparison Regarding Non-Motor Domains:

Correlation with Non-Motor Categories

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MDS Abstracts - https://www.mdsabstracts.org/abstract/fatigue-in-parkinsons-disease-is-it-primary-or-secondary/