FATIGUE AND PARKINSON'S DISEASE - A PROSPECTIVE ANALYSIS

Abstract: Background: Parkinson's disease (PD) is a neurological disorder that manifests with both motor and non-motor symptoms, including bradykinesia, resting tremors, and stiffness. Fatigue is one of the most debilitating non-motor symptoms, affecting 28% to 58% of PD patients. Despite its prevalence, the origin and impact of fatigue on the quality of life in PD patients are not well understood. Objective: This study aims to investigate the relationship between fatigue and Parkinson's disease, focusing on its semiological components. Methods: A prospective and comparative study was conducted at the Neuroscience Center of the Hospital in Pakistan. Participants aged 20 to 70 were divided into two groups: the Parkinson's Disease Group (PDG, n=40) and the Control Group (CG, n=37). Neuropsychiatric evaluations included the Mini-Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Hamilton Depression Rating Scale (HAMD). Clinical evaluations used the Hoehn and Yahr (H&Y) stage, the Unification of Parkinson's Disease Rating Scale (UPDRS), and the Schwab and England (SE) scale. Fatigue was assessed using the Chalder Scale (CFS) and the Fatigue Severity Scale (FSS). Results: No significant variations were observed in the Fatigue Severity Scale (FSS) between the groups. Depression was more prevalent in PDG, with significant differences at moderate and severe (ρ = 0.007) and mild and severe (ρ = 0.016) levels. A stronger link between age and fatigue was found in individuals aged 50 to 70. Half of the patients experienced extreme fatigue within the same illness period, with 46.7% having a disease duration of at least five years. According to the SE scale, daily living activities were completed at 60% (5%), 70% (5%), 80% (65%), and 90% (26%) levels. Conclusion: Fatigue significantly impacts PD patients, correlating with depression and decreased functional capacity in activities of daily living. Patients with longer and more severe disease durations experience fatigue more frequently. These findings underscore the need for integrated diagnostic and treatment approaches to enhance the quality of life for PD patients. Further research is necessary to better understand the relationship between fatigue and Parkinson's disease.