Repercussão da fadiga no desempenho motor e qualidade de vida em pacientes com Doença de Parkinson

Abstract

Fatigue is a symptom with a significant prevalence in Parkinson's disease that contributes to a worse quality of life, however, there is little information in the medical literature on the subject. This study aims to identify fatigue as a primary non-motor symptom in patients with Parkinson's disease, as well as to observe its association with quality of life and motor impairment. Patients between 50 and 85 years on stable doses of anti-parkinsonian medication were selected, excluding those with dementia, clinical comorbidities or in use of fatigue-related medications, and modified Hoehn & Yahr scale  4. The selected participants were submitted to the same protocol: evaluation of comorbidities and medications in use, laboratory tests and screening for depressive symptoms, apathy and excessive daytime sleepiness, excluding those with some secondary cause of fatigue. Then, they were screened for the presence (FADECOM) or not (FADSEM) of fatigue and divided into two groups according to the results of the evaluations. Comparisons were made between quality of life, levodopa equivalent daily dose, age, disease duration and motor impairment between the groups. No correlation was observed between the presence of fatigue and age (p <0.99 r = 0.00), disease duration (p <0.16 r = 0.20), UPDRS-III (p <0.16 r = 0.20) and levodopa equivalent daily dose (p <0.94). However, those in the FADCOM group presented worse quality of life (total PDQ-39) indexes (p <0.00). We concluded that fatigue is manifested as an independent factor, that is, primary, being associated with a worse quality of life, but no relation is observed between the presence of fatigue, age, severity of motor symptoms and equivalent dose of levodopa. Thus, despite the great benefit of dopaminergic drugs to ameliorate the motor symptoms of Parkinson's disease, there may be other independent mechanisms for triggering fatigue.