NeuralCipher Research overview
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One of the most common and usually very incapacitating non-motor manifestations in PD, fatigue is both a symptom experienced by up to two-thirds of all patients and significantly troubling in relation to quality of life. This review will give a thorough overview of complex pathophysiology, prevalence, course, specific clinical presentation, methods of assessment, and current strategies in the management of fatigue in PD. Finally relating to dysfunction in dopaminergic and non-dopaminergic pathways, neuroinflammation, genetic predispositions, and neuroendocrine and metabolic dysregulation, the underlying mechanisms of fatigue in PD relate to the latter disorders. Generally, prevalence rates of fatigue in PD have been reported to be within the bracket of 36-60%, underlining the need for standardization of assessment tools and a universal definition. Fatigue in PD appear “feeling of abnormal and overwhelming tiredness and lack of energy that is distinct both qualitatively and quantitatively from normal tiredness, clinically many times pre-dating the manifestation of motor symptoms by years. The differentiation of fatigue from sleepiness, apathy, and depression is very important for PD symptoms and treatment. The present available assessment tools include mainly patient-reported questionnaires the Fatigue Severity Scale and Parkinson's Disease Fatigue Scale. The management include both pharmacological and non-pharmacological managements. Well, though drugs like methylphenidate and rasagiline hold promise, an equally important role is played by physical exercise, cognitive behavioral therapy, and the management of sleep disorders. Further research is needed to clarify the complex pathophysiology of fatigue in PD, with a view toward the identification of objective biomarkers, and the development of targeted and effective treatment strategies for relief of this common and burdensome symptom.
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