摘要
Abstract
Objective To explore the clinical characteristics of fatigue in patients with heterogeneous Parkinson's disease (PD) and the associations of fatigue with motor and non-motor symptoms to identify the ascription of symptoms,in order to hunt for therapeutic strategies to relieve symptoms.Methods We collected clinical data of one hundred and forty-four PD out-patients who visited the neurology department or in-patients in our hospital from April 2014 to June 2016.All patients were grouped based on heterogeneous principles of classification and were evaluated by fatigue scale-14 (FS-14),fatigue severity scale (FSS),motor symptoms (MS) scale,non-motor symptoms (NMS) scale and activities of daily living (PDQ39) scale.Results Of all 144 cases taking part in fatigue evaluation,60 cases (41.4%) had fatigue symptom among whom there were 10 cases (6.9%) identified at the early stage of PD without other NMS symptoms.According to comparisons between different groups in heterogeneous PD patients,our study showed that late-onset type,stiffness as chief symptom,female and patients at moderate and advanced stage of rigidity type,the female and the middle and late stage.Univariate analysis showed that age,PD duration,H-Y grade,MS scores (including the total scores of UPDRS part Ⅲ and scores of UPDRS part Ⅳ) in fatigue group were significantly higher than those in non-fatigue group (P<0.05).NMSS scores showed that the degree and frequency of NMS in the fatigue group were significantly higher than those in the non-fatigue group,and there were significant differences between the two groups (P<0.05).Furthermore,the fatigue group indicated higher levels in mental state (UPDRS part Ⅰ),depression (HAMD),anxiety (HAMA) and daytime sleepiness (ESS) than the non-fatigue group (P<0.05).Although MMSE scores verified normal intelligence in both two groups without statistical difference (P>0.05),the fatigue group showed the decreasing tendency of MMSE scores.The fatigue group showed higher scores of UPDRS part Ⅱ and PDQ39,but lower Schwab scores than the non-fatigue group (P<0.05).The Multiple linear regression analysis showed that fatigue had close correlations with NMSS degree,depression and anxiety.Conclusion PD patients have high incidence of fatigue and heterogeneous PD patients have different incidence.Univariate analysis shows that PD patients with fatigue present longer duration of disease,severer motor symptoms,more non-motor symptoms and worse quality of life.NMSS degree,depression and anxiety may be responsible for fatigue.The occurrence of fatigue has nothing to do with MS and NMS in the part of the fatigue group,which indicates that fatigue can be one of independent non-motor symptoms.关键词
帕金森病/疲劳/异质性/运动症状/非运动症状Key words
Parkinson's disease/Fatigue/Heterogeneity/Motor symptoms/Non-Motor symptoms分类
医药卫生
