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The associations between fatigue, apathy, and depression in Parkinson's disease.
Acta Neurol Scand. 2015 Feb; 131(2):80-7.AN

Abstract

OBJECTIVES

Fatigue and apathy are two of the most common and most disabling non-motor symptoms of Parkinson's disease (PD). They have a high coincidence and can often be confused; moreover, their relationship is not fully understood. The aim of our study was to describe the coincidence of apathy with different fatigue domains in the presence/absence of depression and to separately describe the associations of different aspects of primary and secondary fatigue with apathy and other clinical and disease-related factors.

MATERIALS AND METHODS

A total of 151 non-demented patients with PD were examined using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Starkstein Apathy Scale, Multidimensional Fatigue Inventory (MFI), Beck Depression Inventory-II, and Epworth Sleepiness Scale.

RESULTS

The prevalence and severity of fatigue and apathy were significantly higher in depressed PD patients. However, our results show that depression, fatigue, and apathy can be clearly distinguished in PD. Apathy was associated with the MFI's-reduced motivation domain in both depressed and non-depressed patients. However, apathy was associated with mental fatigue aspects only in non-depressed patients, and it was not related to the physical aspects of fatigue in any of the studied groups.

CONCLUSIONS

Although the pathophysiology of fatigue and apathy in PD is clearly multifactorial, in a proportion of PD patients, these symptoms are associated with depression, dopaminergic depletion in the mesocorticolimbic structures, and disruption of the prefrontal cortex-basal ganglia axis. Therefore, in some PD patients, adequate management of depression and optimal dopaminergic medication may improve both fatigue and apathy.

Authors+Show Affiliations

Department of Neurology, Safarik University, Kosice, Slovak Republic; Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic; Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25288130

Citation

Skorvanek, M, et al. "The Associations Between Fatigue, Apathy, and Depression in Parkinson's Disease." Acta Neurologica Scandinavica, vol. 131, no. 2, 2015, pp. 80-7.
Skorvanek M, Gdovinova Z, Rosenberger J, et al. The associations between fatigue, apathy, and depression in Parkinson's disease. Acta Neurol Scand. 2015;131(2):80-7.
Skorvanek, M., Gdovinova, Z., Rosenberger, J., Saeedian, R. G., Nagyova, I., Groothoff, J. W., & van Dijk, J. P. (2015). The associations between fatigue, apathy, and depression in Parkinson's disease. Acta Neurologica Scandinavica, 131(2), 80-7. https://doi.org/10.1111/ane.12282
Skorvanek M, et al. The Associations Between Fatigue, Apathy, and Depression in Parkinson's Disease. Acta Neurol Scand. 2015;131(2):80-7. PubMed PMID: 25288130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The associations between fatigue, apathy, and depression in Parkinson's disease. AU - Skorvanek,M, AU - Gdovinova,Z, AU - Rosenberger,J, AU - Saeedian,R Ghorbani, AU - Nagyova,I, AU - Groothoff,J W, AU - van Dijk,J P, Y1 - 2014/10/06/ PY - 2014/06/26/accepted PY - 2014/10/8/entrez PY - 2014/10/8/pubmed PY - 2015/5/20/medline KW - Parkinson's disease KW - apathy KW - depression KW - excessive daytime somnolence KW - fatigue SP - 80 EP - 7 JF - Acta neurologica Scandinavica JO - Acta Neurol Scand VL - 131 IS - 2 N2 - OBJECTIVES: Fatigue and apathy are two of the most common and most disabling non-motor symptoms of Parkinson's disease (PD). They have a high coincidence and can often be confused; moreover, their relationship is not fully understood. The aim of our study was to describe the coincidence of apathy with different fatigue domains in the presence/absence of depression and to separately describe the associations of different aspects of primary and secondary fatigue with apathy and other clinical and disease-related factors. MATERIALS AND METHODS: A total of 151 non-demented patients with PD were examined using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Starkstein Apathy Scale, Multidimensional Fatigue Inventory (MFI), Beck Depression Inventory-II, and Epworth Sleepiness Scale. RESULTS: The prevalence and severity of fatigue and apathy were significantly higher in depressed PD patients. However, our results show that depression, fatigue, and apathy can be clearly distinguished in PD. Apathy was associated with the MFI's-reduced motivation domain in both depressed and non-depressed patients. However, apathy was associated with mental fatigue aspects only in non-depressed patients, and it was not related to the physical aspects of fatigue in any of the studied groups. CONCLUSIONS: Although the pathophysiology of fatigue and apathy in PD is clearly multifactorial, in a proportion of PD patients, these symptoms are associated with depression, dopaminergic depletion in the mesocorticolimbic structures, and disruption of the prefrontal cortex-basal ganglia axis. Therefore, in some PD patients, adequate management of depression and optimal dopaminergic medication may improve both fatigue and apathy. SN - 1600-0404 UR - https://www.unboundmedicine.com/medline/citation/25288130/The_associations_between_fatigue_apathy_and_depression_in_Parkinson's_disease_ L2 - https://doi.org/10.1111/ane.12282 DB - PRIME DP - Unbound Medicine ER -