Objective: to investigate the relationship between urinary dysfunction and fatigue syndrome in Parkinson`s disease

Background: Fatigue syndrome (FS) is an overwhelming sense of tiredness, lack of energy and feeling of exhaustion. The prevalence of fatigue in Parkinson’s disease (PD) ranges from 35% to 60%. Urinary dysfunction (UD) is another one of the most frequent nonmotor symptoms in PD. Between both syndromes a link could exist. The urological problems can provoke development of FS among PD patients

Methods: We examined 80 non-demented PD patients. Mean age was 63,4±9,7 years. Mean PD duration was 6,1±2,5 years. Mean Hoehn&Yahr stage was 2,7±0,8. Patients were divided into two groups according to the presence (PD-F group, n=47) or absence (PD-NF group, n=33) of fatigue. Presence of fatigue was defined as score>3,3 on the Parkinson Fatigue Scale (PFS). Patients were administered Autonomic disturbance`s scale in PD patients (ADS), International Prostate Symptom Score survey and urinalysis.

Results: Mean PFS score was 3,75±0,25 in PD-F group, and 2,2±0,5 in PD-NF group. Autonomic disturbances were moderate in PD-F group (8,1±2,4), in PD – NF group–light (4,5±3,5). Mean IPSS score was 15±4,5 in PD-F group, and 6,4±2.3 in PD-NF group. The UD and fatigue score were related (p=0.01). In PD-F group more often occurred leucocytes in urine comparing with PD-NF group (p<0,05) . A relationship was found between nocturia and FSS score(p=0,003).

Conclusions: FS in PD may be influenced by multitude of factors. It is associated with autonomic disturbances, link with urological problems seems quite evident. This fact reflects possible common pathway in the genesis of both symptoms. Uro-genital dysfunction can be associated with FS in some cases of PD and could serve as a prognostic marker of FS occurrence. This fact can imply existence of chronical inflammatory site as one of the sources of FS. Link between nocturia and FS can imply the role of dopamine deficiency in the genesis of both syndromes. Association between FS and UD needs further studies

References: 1. Jost WH. Autonomic Dysfunction in Parkinson’s Disease: Cardiovascular Symptoms, Thermoregulation, and Urogenital Symptoms. Int Rev Neurobiol. 2017;134:771-785. doi: 10.1016/bs.irn.2017.04.003. 2. Dagur G, Warren K et al. Neuro-urological manifestations of Parkinson’s disease. Int J Neurosci. 2015 Aug 17.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-urinary-dysfunction-on-fatigue-syndrome-in-parkinsons-disease/