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Fatigue and apathy

V Gilard, F-X Ferracci, O Langlois, S Derrey, F Proust, S Curey
BACKGROUND AND OBJECTIVES: Survivors of aneurysmal subarachnoid hemorrhage (aSAH) commonly experience sleep disorders resulting in asthenia. The objective of this prospective study was to determine, in a cohort of patients with treated ruptured intracranial aneurysm (IA), the proportion of asthenia at 2months, in a cohort of patients treated with melatonin and in a control cohort. PATIENTS AND METHODS: Twenty consecutive patients admitted for the treatment of ruptured IA and able to answer a standardized questionnaire were included in the study...
November 16, 2016: Neuro-Chirurgie
S O Ongre, J P Larsen, O B Tysnes, K Herlofson
BACKGROUND AND PURPOSE: Fatigue is a common and disabling non-motor symptom in Parkinson's disease (PD). The pathogenesis is unknown, and the treatment options are limited. The aim of the present study was to investigate the development of fatigue during the first year after diagnosis. METHODS: The study design was a prospective, controlled population-based longitudinal cohort study, comprising 181 de novo, drug-naïve patients with PD and 162 control participants...
September 26, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Davide Martino, Tiziano Tamburini, Panagiotis Zis, Gavril Rosoklija, Giovanni Abbruzzese, Kallol Ray-Chaudhuri, Elisa Pelosin, Laura Avanzino
BACKGROUND: Objective measures of physical and cognitive fatigability do not correlate with subjective Parkinson's disease (PD)-related fatigue. The relationship of subjective PD-related fatigue to tasks combining cognitive and motor effort has never been explored. METHODS: Forty-four right-handed, non-demented PD patients, 22 with (PD-F) and 22 without (PD-NF) fatigue, were tested using a sensor-engineered glove on their more affected hand. Patients performed sequential opposition finger movements following a metronome at 2 Hz for 5 min (cued task), and for another minute following a 2-min rest...
August 31, 2016: Parkinsonism & related Disorders
Melanie E Cusso, Kenneth J Donald, Tien K Khoo
Parkinson's disease (PD) is a neurological disorder that is associated with both motor and non-motor symptoms (NMS). The management of PD is primarily via pharmaceutical treatment; however, non-pharmaceutical interventions have become increasingly recognized in the management of motor and NMS. In this review, the efficacy of physical activity, including physiotherapy and occupational therapy, as an intervention in NMS will be assessed. The papers were extracted between the 20th and 22nd of June 2016 from PubMed, Web of Science, Medline, Ovid, SportsDiscuss, and Scopus using the MeSH search terms "Parkinson's," "Parkinson," and "Parkinsonism" in conjunction with "exercise," "physical activity," "physiotherapy," "occupational therapy," "physical therapy," "rehabilitation," "dance," and "martial arts...
2016: Frontiers in Medicine
Paulo Bugalho, Tânia Lampreia, Rita Miguel, Marcelo D Mendonça, André Caetano, Raquel Barbosa
The prevalence of non-motor symptoms (NMS) in Parkinson's Disease (PD) has varied between studies. Their interrelation isn't totally understood. Also, the relative importance of each symptom, regarding its impact on activities of daily living (ADL) and health related quality of life (HRQL), remains debatable. We assessed all PD patients attending a Portuguese tertiary movement disorders center during one year (n = 134), with ADL, HRQL and other clinical scales approved for identifying the most relevant NMS in PD...
2016: Scientific Reports
Ana M Novo, Sonia Batista, Joana Tenente, Carla Nunes, Carmo Macário, Lívia Sousa, Freire Gonçalves
Apathy has been recognized as a frequent symptom in multiple sclerosis (MS) but uncertainty remains about its prevalence and clinical correlates. Therefore, the objective of this work was to assess the prevalence of apathy in patients with MS and to identify clinical and demographic correlates. A case-control study with 30 patients and 30 healthy controls matched for age, gender and education was performed. Apathy diagnosis was established using Robert et al.'s criteria. Additionally, apathy was assessed using the 10-item short version of the clinical-rated Apathy Evaluation Scale (AES-C-10)...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Francesca Magrinelli, Alessandro Picelli, Pierluigi Tocco, Angela Federico, Laura Roncari, Nicola Smania, Giampietro Zanette, Stefano Tamburin
Cardinal motor features of Parkinson's disease (PD) include bradykinesia, rest tremor, and rigidity, which appear in the early stages of the disease and largely depend on dopaminergic nigrostriatal denervation. Intermediate and advanced PD stages are characterized by motor fluctuations and dyskinesia, which depend on complex mechanisms secondary to severe nigrostriatal loss and to the problems related to oral levodopa absorption, and motor and nonmotor symptoms and signs that are secondary to marked dopaminergic loss and multisystem neurodegeneration with damage to nondopaminergic pathways...
2016: Parkinson's Disease
Ruwei Ou, Wei Song, Qianqian Wei, Ke Chen, Bei Cao, Yanbing Hou, Bi Zhao, Huifang Shang
Objectives. To explore the clinical correlates of nonmotor symptoms (NMS) in progressive supranuclear palsy (PSP) and their differences from healthy controls and patients with Parkinson's disease (PD). Methods. Twenty-seven PSP patients, 27 age- and gender-matched healthy controls (HC), and 27 age- and gender-matched PD patients were included for this case-control study. NMS were assessed using the Nonmotor Symptoms Scale (NMSS, including 9 domains). Results. All PSP patients reported NMS. The frequency and severity of "sleep/fatigue," "mood/apathy," "attention/memory," "gastrointestinal," "sexual dysfunction," and "miscellaneous" domains in PSP group were significantly higher than those in HC group (P < 0...
2016: Parkinson's Disease
Sarah K Hendred, Erin R Foster
OBJECTIVE: To investigate the distribution, internal consistency reliability, and convergent and discriminant validity of the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) in persons with mild to moderate Parkinson disease (PD). DESIGN: Cross-sectional. SETTING: Movement disorders center. PARTICIPANTS: Convenience sample of people with PD (n=96) recruited from a movement disorders center and controls (n=60) recruited from the community (N=156)...
December 2016: Archives of Physical Medicine and Rehabilitation
Raphaël Le Bouc, Lionel Rigoux, Liane Schmidt, Bertrand Degos, Marie-Laure Welter, Marie Vidailhet, Jean Daunizeau, Mathias Pessiglione
UNLABELLED: Motor dysfunction (e.g., bradykinesia) and motivational deficit (i.e., apathy) are hallmarks of Parkinson's disease (PD). Yet, it remains unclear whether these two symptoms arise from a same dopaminergic dysfunction. Here, we develop a computational model that articulates motor control to economic decision theory, to dissect the motor and motivational functions of dopamine in humans. This model can capture different aspects of the behavior: choice (which action is selected) and vigor (action speed and intensity)...
June 22, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
ShuShan Zhang, RuWei Ou, XuePing Chen, Jing Yang, Bi Zhao, XiaoQin Yuan, QianQian Wei, Bei Cao, Hui-Fang Shang
BACKGROUND: Cognitive dysfunction is common in Parkinson's disease (PD). A comprehensive understanding of cognitive dysfunction and its correlative factors in Chinese PD patients were not available. METHODS: This cross-sectional study included 454 PD patients. Cognitive function was evaluated using the Montreal Cognitive Assessment. Non-motor symptoms were assessed using the Non-Motor Symptoms Scale (NMSS), and depression and anxiety were assessed using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale, respectively...
May 2016: Neurological Research
Lucia Ricciardi, Gina Ferrazzano, Benedetta Demartini, Francesca Morgante, Roberto Erro, Christos Ganos, Kailash P Bhatia, Alfredo Berardelli, Mark Edwards
BACKGROUND: Although Parkinson's disease (PD) is defined by its motor symptoms, it is now well recognised that cognitive, affective and emotion domains are also impaired. The pathophysiology of these disabling non-motor symptoms (NMS) remains unclear; recently the involvement of limbic areas, including the insula, in the neurodegenerative process has been suggested to have a key role. These areas, and the insula in particular, are also been suggested as key regions for interoception; interoceptive sensitivity (IS) is a measure of the accuracy of perception of sensations from inside the body related to the function of internal organs...
May 15, 2016: Journal of the Neurological Sciences
Anna Castrioto, Stéphane Thobois, Sebastien Carnicella, Audrey Maillet, Paul Krack
Neuropsychiatric symptoms are common and disabling in PD. Their neurobiological bases are complex, partly because of the disease itself and partly because of the dopaminergic treatment. The aim of this review is to focus on the emotional manifestations stemming from the neurodegenerative process itself. We focus on depression, anxiety, apathy, and fatigue, which can all be part of the clinical spectrum of premotor disease and may be improved or masked by medications targeting parkinsonian motor signs or psychiatric symptoms as the disease progresses...
August 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Benzi M Kluger, Karen Herlofson, Kelvin L Chou, Jau-Shin Lou, Christopher G Goetz, Anthony E Lang, Daniel Weintraub, Joseph Friedman
Fatigue is one of the most common and disabling symptoms in Parkinson's disease (PD). Since fatigue was first described as a common feature of PD 20 years ago, little progress has been made in understanding its causes or treatment. Importantly, PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. In response, the Parkinson Disease Foundation and ProjectSpark assembled an international team of experts to create recommendations for clinical research to advance this field...
May 2016: Movement Disorders: Official Journal of the Movement Disorder Society
K M Prakash, N V Nadkarni, W-K Lye, M-H Yong, E-K Tan
BACKGROUND AND PURPOSE: Non-motor symptoms (NMSs) are common amongst patients with Parkinson's disease (PD); however, little is known about their influence on the health-related quality of life (QoL) over a defined follow-up period. The study was aimed to establish the impact of NMSs on the QoL of patients with PD over a 2-year follow-up period. METHOD: A total of 227 newly referred PD patients were prospectively recruited between 2013 and 2014. The Non-Motor Symptoms Scale was used to evaluate NMSs burden whilst QoL was assessed with the Parkinson's Disease Questionnaire-39 items...
May 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Kelvin L Chou, Vikas Kotagal, Nicolaas I Bohnen
BACKGROUND: Fatigue is disabling in Parkinson disease. It is often associated with other non-motor symptoms, but little is known about its underlying pathophysiology. OBJECTIVE: To investigate neuroimaging (using dopaminergic and cholinergic PET) and clinical factors associated with fatigue severity in PD. METHODS: 133 PD subjects (96M/37F) completed the Fatigue Severity Scale, Movement Disorders Society-Sponsored Revision of the Unified PD Rating Scale (MDS-UPDRS), Hoehn-Yahr staging, validated scales for depression, anxiety, apathy, sleep, and cognition, and underwent [(11)C]methyl-4-piperidinyl propionate (PMP) acetylcholinesterase (AChE) and [(11)C]dihydrotetrabenazine (DTBZ) monoaminergic PET imaging...
February 2016: Parkinsonism & related Disorders
Jau-Shin Lou
BACKGROUND: Fatigue is common in patients with Parkinson's disease (PD). It occurs at every stage of PD and affects quality of life. Fatigue severity worsens over time as PD progresses, and it is associated with other non-motor symptoms such as apathy, depression, sleep disorder, and cognitive dysfunction. PURPOSE: In this literature review, I discuss the measurement and pathophysiology of fatigue and fatigability. There are no evidence-based treatments for fatigue and fatigability available...
2015: NeuroRehabilitation
Anette Schrag, Anna Sauerbier, Kallol Ray Chaudhuri
Nonmotor manifestations in Parkinson's disease (PD) encompass a range of clinical features, including neuropsychiatric problems, autonomic dysfunction, sleep disorders, fatigue, and pain. Despite their importance for patients' quality of life, the evidence base for their treatment is relatively sparse. Nevertheless, the last few years have seen a number of new trials starting that specifically address nonmotor features as an outcome measure in clinical trials. Large randomized, controlled trials in the last 3 years reported improvement of psychosis with the new selective serotonin 5-HT2A inverse agonist pimavanserin and of postural hypotension with the oral norepinephrine precursor droxidopa...
September 15, 2015: Movement Disorders: Official Journal of the Movement Disorder Society
Benjamin Gallais, Michèle Montreuil, Marcela Gargiulo, Bruno Eymard, Cynthia Gagnon, Luc Laberge
BACKGROUND: Apathy in DM1 has long been acknowledged in clinical practice. However, a major drawback is that the concept has been only sparsely explored in previous specific studies. This study aimed to determine the prevalence of apathy in myotonic dystrophy (DM1), to compare it with facioscapulohumeral dystrophy (FSHD) patients and normal healthy controls, and explore its relationship to psychopathological features and cognitive function. METHODS: Levels of apathy in 38 DM1 patients with adult phenotypes were compared with 19 patients with FSHD and 20 matched controls...
2015: BMC Neurology
Umer Akbar, Joseph H Friedman
The non-motor symptoms of Parkinson's disease (PD) have been attracting increasing attention due to their ubiquitous nature and their often devastating effects on the quality of life. Behavioral problems in PD include dementia, depression, apathy, fatigue, anxiety, psychosis, akathisia, personality change, sleep disorders and impulse control disorders. Some of these are intrinsic to the neuropathology while others occur as an interplay between pathology, psychology and pharmacology. While few data exist for guiding therapy, enough is known to guide therapy in a rational manner...
2015: Expert Review of Neurotherapeutics
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