The associations between fatigue, apathy, and depression in Parkinson's disease

Škorvánek, Matej; Gdovinová, Zuzana; Rosenberger, Jaroslav; Saeedian, Radka Ghorbani; Nagyová, Iveta; Groothoff, Johan W.; Dijk, Jitse P. van

doi:10.1111/ane.12282

Cited by 106 publications

(88 citation statements)

References 36 publications

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“…Multiple, but not all, studies in PD show a significant correlation between depression and fatigue. 8 Anxiety and apathy also correlate with fatigue 21,22 but many fatigued patients are not depressed, anxious, or apathetic. 8 Several studies suggest that cognitive performance, frontal lobe activity, and self-reported cognitive impairment are associated with fatigue.…”

Section: Clinical Review Of Fatigue In Pdmentioning

confidence: 99%

Fatigue in Parkinson’s disease: report from a multidisciplinary symposium

Friedman

Beck

Chou

et al. 2016

npj Parkinson's Disease

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Fatigue is a severe problem for many people living with Parkinson's disease (PD). Best estimates suggest that more than 50% of patients experience this debilitating symptom. Little is known about its etiology or treatment, making the understanding of fatigue a true unmet need. As part of the Parkinson's Disease Foundation Community Choice Research Program, patients, caregivers, and scientists attended a symposium on fatigue on 16 and 17 October 2014. We present a summary of that meeting, reviewing what is known about the diagnosis and treatment of fatigue, its physiology, and what we might learn from multiple sclerosis (MS), depression, and cancer—disorders in which fatigue figures prominently too. We conclude with focused recommendations to enhance our understanding and treatment of this prominent problem in PD.

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Section: Clinical Review Of Fatigue In Pdmentioning

confidence: 99%

Fatigue in Parkinson’s disease: report from a multidisciplinary symposium

Friedman

Beck

Chou

et al. 2016

npj Parkinson's Disease

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show abstract

“…Fatigue is regarded as an independent non-motor symptom in PD, and its etiology is multifactorial [27, 28]. The striato-thalamo-frontal cortical pathway is strongly associated with central fatigue.…”

Section: Discussionmentioning

confidence: 99%

Association between White Matter Lesions and Non-Motor Symptoms in Parkinson Disease

et al. 2018

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Background: There are only few studies exploring the relationship between white matter lesions (WMLs) and non-motor symptoms in Parkinson disease (PD). This study aimed to investigate the association between WMLs and the severity of non-motor symptoms in PD. Methods: The severity of motor dysfunction, cognitive impairment, and non-motor symptoms was assessed by various scales in 105 PD patients. We used a visual semiquantitative rating scale and divided the subjects into four groups: no, mild, moderate, and severe WMLs. We compared the means of all scores between the four groups and analyzed the association between the severity of WMLs and the specific domain of non-motor symptoms. Results: The non-motor symptoms as assessed by the Non-Motor Symptoms Scale, Parkinson’s Disease Questionnaire (PDQ-39), Parkinson’s Disease Sleep Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neuropsychiatric Inventory (NPI), and Parkinson Fatigue Scale (PFS) were significantly worse in the patients with moderate and severe WMLs than in those without WMLs. Compared with the no WML group, the scores for motor dysfunction were significantly higher in the mild, moderate, and severe WML groups. The scores for cognitive dysfunction were significantly higher in the patients with severe WMLs than in those without WMLs. The severity of WMLs showed linear associations with PFS, BDI, BAI, NPI, and PDQ-39 scores. The severity of WMLs also correlated linearly with scores for motor and cognitive dysfunction. Conclusions: Among the non-motor symptoms, fatigue, depression, anxiety, and quality of life were significantly affected by WMLs in PD. Confirmation of the possible role of WMLs in non-motor symptoms associated with PD in a prospective manner may be crucial not only for understanding non-motor symptoms but also for the development of treatment strategies.

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“…Whilst apathy is a common syndrome associated with altered motivation [2, 12], it is also frequently comorbid with other states which may have symptoms of reduced motivation, particularly depression, anhedonia and fatigue [3, 4, 15, 16]. This raises the question of the extent to which apathy can be meaningfully distinguished from these other conditions and whether they might perhaps be associated with discrete dimensions of apathy in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Distinct Subtypes of Apathy Revealed by the Apathy Motivation Index

et al. 2017

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Apathy is a debilitating but poorly understood disorder characterized by a reduction in motivation. As well as being associated with several brain disorders, apathy is also prevalent in varying degrees in healthy people. Whilst many tools have been developed to assess levels of apathy in clinical disorders, surprisingly there are no measures of apathy suitable for healthy people. Moreover, although apathy is commonly comorbid with symptoms of depression, anhedonia and fatigue, how and why these symptoms are associated is unclear. Here we developed the Apathy-Motivation Index (AMI), a brief self-report index of apathy and motivation. Using exploratory factor analysis (in a sample of 505 people), and then confirmatory analysis (in a different set of 479 individuals), we identified subtypes of apathy in behavioural, social and emotional domains. Latent profile analyses showed four different profiles of apathy that were associated with varying levels of depression, anhedonia and fatigue. The AMI is a novel and reliable measure of individual differences in apathy and might provide a useful means of probing different mechanisms underlying sub-clinical lack of motivation in otherwise healthy individuals. Moreover, associations between apathy and comorbid states may be reflective of problems in different emotional, social and behavioural domains.

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The associations between fatigue, apathy, and depression in Parkinson's disease

Cited by 106 publications

References 36 publications

Fatigue in Parkinson’s disease: report from a multidisciplinary symposium

Fatigue in Parkinson’s disease: report from a multidisciplinary symposium

Association between White Matter Lesions and Non-Motor Symptoms in Parkinson Disease

Distinct Subtypes of Apathy Revealed by the Apathy Motivation Index

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