Does fatigue in Parkinson’s disease correlate with autonomic nervous system dysfunction?
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology(2018)
摘要
Background Despite its negative impact on quality of life, fatigue in Parkinson’s disease (PD) remains an under-recognized issue and the underlying pathology is undetermined. Objective To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients. Methods In a Caucasian population of PD patients ( n = 27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests. Results PFS-16 score correlated with disease duration ( R = 0.57, p = 0.002). Fatigue showed a clear correlation with deep breathing test ( R = − 0.53, p = 0.004) but not with the MIBG H/M ratios. Conclusions Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.
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关键词
Autonomic nervous system,Fatigue,Myocardial scintigraphy,Parkinson’s disease
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