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Fatigue In Parkinson’s Disease

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How Are They Alike

Fatigue and Sleepiness in Parkinsons Disease

MS and Parkinsonâs both affect your central nervous system, which includes your brain and spinal cord. Thatâs why they both can affect how you move, sleep, feel, and talk.

These diseases both affect your nerves. MS can break down the coating, called myelin, that surrounds and protects your nerves. In Parkinsonâs, nerve cells in a part of your brain slowly die off.

Both can start out with mild symptoms, but they get worse over time.

Common symptoms of both diseases include:

  • Shaky fingers, hands, lips, or limbs
  • Slurred speech thatâs hard for others to understand
  • Numb or weak limbs that make your walk unsteady
  • Loss of muscle control that often affects one side of your body at first, then later both
  • Spastic limb movements that are hard to control
  • Loss of bladder or bowel control

Depression is another symptom common to both conditions.

Coping With Fatigue In Pd

Fatigue can make motor symptoms, like tremors, seem like they are worst when they are not. Dr. De León has a list of eight things you can do to prevent or improve fatigue, If you still have severe fatigue discuss it with your physician because there are some medications which can help. The key is well adjusted medications, exercise, good nutrition, and rest at least 5 minutes every day.

Medicines For Parkinsons Disease

Medicines can help treat the symptoms of Parkinsons by:

  • Increasing the level of dopamine in the brain
  • Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells
  • Helping control non-movement symptoms

The main therapy for Parkinsons is levodopa. Nerve cells use levodopa to make dopamine to replenish the brains dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy such as nausea, vomiting, low blood pressure, and restlessness and reduces the amount of levodopa needed to improve symptoms.

People living with Parkinsons disease should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, like being unable to move or having difficulty breathing.

The doctor may prescribe other medicines to treat Parkinsons symptoms, including:

  • Dopamine agonists to stimulate the production of dopamine in the brain
  • Enzyme inhibitors to increase the amount of dopamine by slowing down the enzymes that break down dopamine in the brain
  • Amantadine to help reduce involuntary movements
  • Anticholinergic drugs to reduce tremors and muscle rigidity

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Developing A Vaccine Against Chagas Disease

by Andrew J. Yawn, Tulane University

Journal of Microbiology, Immunology and Infection

Tulane University researchers are working on a new Chagas disease vaccine that prevents lasting heart damage, a long-term complication from the tropical disease.

A new pre-clinical study published in the Journal of Microbiology, Immunology and Infection shows the vaccine safely protected heart function in non-human primates, a critical step in moving the research forward to human clinical trials.

Chagas disease is a parasitic disease transmitted predominantly via kissing bug bites. In the Americas, the disease affects 6 million people in 21 countries. Approximately 30,000 new cases arise each year and 14,000 people die from Chagas disease annually.

“Chagas disease is a major parasitic disease in the Americas,” said lead study author Eric Dumonteil, Ph.D., associate professor of tropical medicine at Tulane University School of Public Health and Tropical Medicine. “If left untreated, patients may develop chronic cardiomyopathy, characterized by heart arrhythmias of increasing severity, leading to heart failure.”

There is no vaccine for Chagas currently available. Medications can be effective if administered quickly, but the treatments have limited efficacy as the disease progresses.

“We are developing a therapeutic vaccine aimed at preventing, or at least delaying, the progression of cardiac disease in infected patients,” Dumonteil said.

More information:

Frequency And Evolution Of Apathy

Early warning signs of parkinsons. Part 2

Figure 1 showed that the observed frequency of fatigue in patients with PD over 3-year. Of 174 patients, 61 reported fatigue at baseline . During follow-up, the frequency of fatigue increased to 71/174 after 1-year, 66/172 after 2-year, and 49/134 after 3-year. The changed pattern of the prevalence of fatigue was similar to that of anxiety whereas, it was different from that of sleep disorders, depression, and apathy . Fatigue was not always persistent from one visit to the next in every patient during the 3-year study period . The number of persistent fatigue from baseline to 1-, 2-, and 3-year were 37, 17, and 13, respectively.

Figure 1. The prevalence of fatigue in patients with PD at each visit. The prevalence of fatigue in patients with PD ranged from 35.1 to 40.8% in the early stage within 3 years. The changed pattern of the prevalence of fatigue was similar to that of anxiety rather than that of sleep disorders, depression, and apathy. PD, Parkinsons disease.

Figure 2. Evolution of fatigue in patients with PD over time. The presence of fatigue was not persistent over 3-year. The number of persistent fatigue from baseline to 1-, 2-, and 3-year were 37, 17, and 13, respectively. PD, Parkinsons disease.

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Measurement Of Fatigue And Balance

A randomized crossover design examined each participant twice, once in a fatigued condition and once in a non-fatigued condition. The Visual Analog Scale of Fatigue measured subjective fatigue. The VASF is a quick self-report measure used to quantify subjective perceptions of fatigue during a particular task by marking a 100mm line with 0mm representing no fatigue and 100mm representing maximum fatigue. One can calculate immediate effect of a task on subjective fatigue by subtracting the immediate pre-test measure from the immediate post-test measure designated by each research participant. This ability to measure immediate effects of a task makes the VASF a better option than other self-report measures like the PFS-16 which measure the generalized state of fatigue specifically with persons with PD. Although it has not been studied in PD, the VASF has been found to be more sensitive than other self-report fatigue measures for measuring fatigue in other neurodegenerative diseases .

Balance was measured with MBT, a 14-item test that measures balance in 4 domains: anticipatory balance, reactive postural control, sensory orientation, and dynamic gait. Its validity and reliability in PD has been established .

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Fatigue In Parkinsons Disease And Potential Interventions

This abstract of a literature review discusses the measurement and pathophysiology of fatigue and fatigability. There rare no evidence-based treatments available. Several pilot studies are reviewed on the effects of pharmacological agents and exercise. These provide some insights on the design of future larger clinical trials. Fee for full article at IOS Press.

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Managing Fatigue And Parkinsons Disease: 6 Tips For More Energy

If you are living with Parkinsons disease, you might often feel run-down, out of energy, or even a bone-deep kind of tired that isnt relieved with rest. Those feelings of intense tiredness are known as fatigue a symptom that affects at least 50 percent of those with Parkinsons.

Many MyParkinsonsTeam members experience fatigue. I didnt know it was caused by Parkinsons disease. I just thought I was getting lazy, said one self-proclaimed chronic napper.

Im getting a better understanding of fatigue reading other Parkinsons disease patients stories and knowing Im more normal than I thought, wrote another member, relieved.

Financial Support And Sponsorship

Parkinson’s Disease – Fatigue: Praveen Dayalu

This work was supported by grants from the National Key R& D Program of China , National Natural Science Foundation of China , Jiangsu Provincial Social Development Projects , Jiangsu Provincial Medical Key Discipline Project , Jiangsu Key Laboratory of Neuropsychiatric Diseases , and Suzhou Clinical Research Center of Neurological Disease . This work was also partly supported by grants from the Suzhou Youth Technology Project Foundation and Priority Academic Program Development of Jiangsu Higher Education Institutions.

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What Causes Fatigue In Parkinsons Disease

Parkinsons symptoms are categorized into motor and nonmotor . Fatigue is considered a nonmotor symptom of Parkinsons.

Fatigue associated with any disease can be a result of the disease itself , or it can be the result of the diseases symptoms . In Parkinsons disease, evidence indicates that fatigue is mostly primary. Fatigue is often experienced before motor symptoms first appear. Because fatigue often clusters with other conditions and those conditions can also lead to fatigue, its difficult for researchers to unravel its true causes.

Currently, studies support that the pathophysiology of primary fatigue in people with Parkinsons is related to inflammation and dysfunction in specific parts of the brain. This inflammation and dysfunction particularly affect the basal ganglia the part of the brain involved in controlling motor function and in maintaining the balance of important neurotransmitters, like dopamine and serotonin. One study also found that fatigue in Parkinsons was correlated with reduced frontal lobe circulation. The bottom line? Parkinsons disease disrupts the function of specific parts of the brain to directly cause fatigue.

Support For People Living With Parkinsons Disease

While the progression of Parkinsons is usually slow, eventually a persons daily routines may be affected. Activities such as working, taking care of a home, and participating in social activities with friends may become challenging. Experiencing these changes can be difficult, but support groups can help people cope. These groups can provide information, advice, and connections to resources for those living with Parkinsons disease, their families, and caregivers. The organizations listed below can help people find local support groups and other resources in their communities.

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The Critical Difference Between Sleepiness And Fatigue

Fatigue is a physical or psychological feeling where people feel weary and exhausted and lacking energy. EDS is about needing and having the urge to sleep.

Fatigue is something that people can experience along with EDS however, people who experience fatigue on its ownthe feeling of being tired and out of energy do not also necessarily fall asleep when sedentary, as people who experience EDS often do.

It is estimated that EDS affects up to 50% to 75% of people living with Parkinsons and fatigue is estimated to affect 40% to 60%. Fatigue, however, is more likely to go undiagnosed.

Because the terms fatigue and sleepiness are so heavily linked, and sometimes used interchangeably, research has concluded that fatigue and EDS should be assessed separately in people with Parkinsons so that we can improve our understanding of their overlapping physiology.

With that knowledge, researchers from the University Hospital of Zurich, Switzerland designed a study to determine the overlap between fatigue and EDS and then associate them with other motor and non-motor symptoms as well as dopaminergic medication.

In their study of 88 outpatients, the researchers found that 72% experienced fatigue or EDS and just under half experienced both. Some of the key findings of the study include:

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Changes In Cognition And Parkinsons Disease

Do you or a loved one with Parkinsons disease (PD) feel physically or ...

Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.

Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.

Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.

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Clinical Fatigue Research In Pd

Since the publication of Angelo Mosso’s groundbreaking work on fatigue in 1891, there have been a number of advances and setbacks in the study of fatigue . With a few notable exceptions, such as the Harvard Fatigue Laboratory which made several notable contributions to the field from 1927 to 1947, the first 90 years following Mosso’s publication were marked by sparse research in this field and a questioning of whether a scientific study of fatigue was even possible .

Physical Activity Fatigue And Sleep In People With Parkinsons Disease: A Secondary Per Protocol Analysis From An Intervention Trial

S. Coe


1. Introduction

Parkinsons is a progressive neurological condition, and it is estimated that one in every 350 people in the UK are diagnosed with the condition. Although pharmaceutical interventions are the primary treatment option, exercise is becoming increasingly recognised as an effective addition to commonly used drug treatments for the control of both motor and nonmotor symptoms . There is strong evidence supporting beneficial effects of exercise programs on disease progression, motor and nonmotor symptom management, and health and wellbeing in PwP . Exercise interventions and a dose of 30 minutes or more a week of moderate to vigorous physical activity have been suggested to positively impact on the global nonmotor symptom burden including depression, apathy, fatigue, daytime sleepiness, sleep, and cognition . However, the evidence supporting a positive benefit of exercise to physical activity, fatigue, daytime sleepiness, and sleep is not strong .

2. Methods

2.1. Design
2.2. Setting

Parkinsons assessments were carried out at the Movement Science Laboratory, Oxford Brookes University, Oxford, UK, the intervention took place at community leisure facilities throughout Oxfordshire and Berkshire, and the handwriting sessions took place in the home of the participants.

2.3. Participants

The study received National Health Service ethical approval and was conducted in accordance with the declaration of Helsinki.

2.4. Intervention
2.5. Data Analysis

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Fatigue In Parkinsons Disease: Report From A Multidisciplinary Symposium

A summary of a symposium in October, 2014, reviewing what is known about the diagnosis and treatment of fatigue, its physiology, and what we might learn from other disorders in which fatigue figures prominently, and concluding with focused recommendations to enhance understanding and treatment of fatigue in Parkinsons disease.

Financial Disclosures For The Past 12 Months

Fatigue in Parkinson’s

SM receives research support from the Michael J Fox Foundation , the Parkinson Foundation and Cerevel Therapeutics, was a paid consultant to MJFF, is a study site investigator for a study sponsored by Neuraly Rho, is a study site sub-investigator for a study sponsored by Biogen, and is contracted with Deep Brain Innovations, LLC. MD was an employee of the sponsor, MJFF, at the time this work was done. CK is an employee of MJFF. CM was a paid consultant for Acorda Therapeutics, on the advisory board of Denali therapeutics, received honoraria for teaching from EMD Serono, a steering committee member for MJFF Grants Canadian Institutes of Health Research, Parkinsons Foundation , National Institutes of Health , International Parkinson and Movement Disorders Society, and is contracted with Grey Matter Technologies. LC receives research support from MJFF, has received travel payment from MJFF to MJFF conferences, is a paid consultant to MJFF, receives research support from the UPMC Competitive Medical Research Fund, is study site investigator for a study sponsored by Biogen, is a site sub-investigator for a study sponsored by Voyager, received payment from Elsevier , and receives royalties from Wolters Kluwel . All other authors have no financial disclosures.

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How Do Treatments Differ

MS treatments can ease your symptoms during an attack or slow down the diseaseâs effects on your body.

Steroids like prednisone calm the inflammation that damages your nerves.

Plasma exchange is another therapy if steroids donât work. Your doctor will use a machine to remove the plasma portion of your blood. The plasma gets mixed with a protein solution and put back into your body.

Some people with both diseases who take anti-inflammatory medicines like steroids see their Parkinsonâs symptoms get better.

Disease-modifying treatments slow down MS nerve damage and disability. They include:

Medications to treat Parkinsonâs either raise your dopamine levels or offer a substitute. They can ease Parkinsonâs symptoms like tremors. Over time, they may become less effective.

Medicines used to treat Parkinsonâs include:

Deep-brain stimulation is another treatment for Parkinsonâs. A doctor places electrodes into your brain. They send out electric pulses that ease symptoms in your body.

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Diagnosis Of Parkinsons Disease

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.

A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.

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Take Care Of Your Mental Health

Fatigue can also be a side effect of depression, which can occur alongside fatigue in people with Parkinsons. Get screened for depression and anxiety, and talk to your doctor about possible treatments. Pharmaceutical approaches and therapy can help alleviate mental health issues that are making your fatigue worse.

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Fatigue In Parkinson

I am a very active person, but deep fatigue must be addressed with rest. Taking a day to rest is not in my nature. It makes me feel like a sloth. Yet, when deep fatigue hits me, the best remedy is to do just that take the day off! I limit myself to one day of physical rest, very rarely two days . I also find that the mind must rest with the body. Getting the mind to a quiet place is the practice of meditation, in whatever form suits the moment. At the height of deep fatigue, meditation can be very difficult, but not impossible. At times, it has taken me four hours to quiet my mind and body to get rejuvenating rest.

But there is a caution here: Be wary of using rest as an excuse to procrastinate. In another column, Ill address the link of scenario looping to set-shifting issues and difficulty initiating new tasks. Basically, getting off the sofa can be problematic if I stay there too long. Perhaps this seems contradictory to my history as a highly active person, but that is the nature of PDs nonmotor effects. Once off the sofa, I make myself shift into a physical task, followed by a short rest and then some type of mental task. There is always some resistance to overcome to do this to get off the sofa but the rest is absolutely necessary to stop the deep fatigue.

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