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Fatigue in levodopa-naïve subjects with Parkinson disease

Identifieur interne : 000197 ( Ncbi/Curation ); précédent : 000196; suivant : 000198

Fatigue in levodopa-naïve subjects with Parkinson disease

Auteurs : G. Schifitto ; J Friedman ; D. Oakes ; L. Shulman ; C Comella ; K. Marek ; S. Fahn

Source :

Neurology [ 0028-3878 ] ; 2008.

RBID : PMC:2937041

English descriptors

KwdEn :
- Aged, Antiparkinson Agents (therapeutic use), Brain (metabolism), Carbidopa (therapeutic use), Double-Blind Method, Fatigue (etiology), Female, Humans, Levodopa (therapeutic use), Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Tomography, Emission-Computed, Single-Photon.
MESH :
- chemical , therapeutic use : Antiparkinson Agents, Carbidopa, Levodopa.
- complications : Parkinson Disease.
- drug therapy : Parkinson Disease.
- etiology : Fatigue.
- metabolism : Brain.
- physiopathology : Parkinson Disease.
- Aged, Double-Blind Method, Female, Humans, Male, Middle Aged, Tomography, Emission-Computed, Single-Photon.

Abstract

Background:

Fatigue is a common complaint in Parkinson disease (PD). We investigated fatigue in a cohort of previously untreated patients with early PD enrolled in the Earlier vs Later Levodopa (ELLDOPA) clinical trial.

Methods:

A total of 361 patients were enrolled in the randomized, double-blind, placebo-controlled ELLDOPA trial and assigned to receive placebo or carbidopa-levodopa 37.5/150 mg, 75/300 mg, or 150/600 mg daily for 40 weeks, followed by a 2-week medication washout period. Subjects who scored >4 on the Fatigue Severity Scale were classified as fatigued. PD severity was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr scale, and Schwab-England Activities of Daily Living Scale. A subgroup of subjects underwent [¹²³I]-β-CIT SPECT to measure striatal dopamine transporter density.

Results:

Of the 349 ELLDOPA subjects who completed fatigue measures, 128 were classified as fatigued at baseline. The fatigued group was significantly more impaired neurologically (UPDRS, all subscales and Hoehn and Yahr staging) and functionally (Schwab-England Scale) but no significant differences were observed in β-CIT measurements between the two groups. Analysis of covariance showed a greater increase in fatigue score from baseline to the end of the 2-week washout in the placebo group (0.75 points) than in the three groups receiving levodopa (increases of 0.30 [150 mg/day], 0.36 [300 mg/day], and 0.33 [600 mg/day]; p = 0.03 for heterogeneity).

Conclusions:

Fatigue is a frequent symptom in early, untreated, non-depressed patients with Parkinson disease (PD), affecting over 1/3 of the patients in this cohort at baseline and 50% by week 42. Fatigue was associated with the severity of PD, and progressed less in patients treated with levodopa.

GLOSSARY

ELLDOPA

= Earlier vs Later Levodopa;

FSS

= Fatigue Severity Scale;

Ham-D

= Hamilton Depression Scale;

= Parkinson disease;

UPDRS

= Unified Parkinson's Disease Rating Scale.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937041

DOI: 10.1212/01.wnl.0000324862.29733.69
PubMed: 18695158
PubMed Central: 2937041

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Le document en format XML

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<author><name sortKey="Schifitto, G" sort="Schifitto, G" uniqKey="Schifitto G" first="G" last="Schifitto">G. Schifitto</name>
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<author><name sortKey="Friedman, J H" sort="Friedman, J H" uniqKey="Friedman J" first="J" last="Friedman">J Friedman</name>
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<author><name sortKey="Oakes, D" sort="Oakes, D" uniqKey="Oakes D" first="D" last="Oakes">D. Oakes</name>
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<author><name sortKey="Shulman, L" sort="Shulman, L" uniqKey="Shulman L" first="L" last="Shulman">L. Shulman</name>
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<author><name sortKey="Comella, C L" sort="Comella, C L" uniqKey="Comella C" first="C" last="Comella">C Comella</name>
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<author><name sortKey="Marek, K" sort="Marek, K" uniqKey="Marek K" first="K" last="Marek">K. Marek</name>
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<author><name sortKey="Fahn, S" sort="Fahn, S" uniqKey="Fahn S" first="S" last="Fahn">S. Fahn</name>
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<author><name sortKey="Friedman, J H" sort="Friedman, J H" uniqKey="Friedman J" first="J" last="Friedman">J Friedman</name>
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<author><name sortKey="Oakes, D" sort="Oakes, D" uniqKey="Oakes D" first="D" last="Oakes">D. Oakes</name>
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<author><name sortKey="Shulman, L" sort="Shulman, L" uniqKey="Shulman L" first="L" last="Shulman">L. Shulman</name>
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<series><title level="j">Neurology</title>
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<term>Antiparkinson Agents (therapeutic use)</term>
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<term>Carbidopa (therapeutic use)</term>
<term>Double-Blind Method</term>
<term>Fatigue (etiology)</term>
<term>Female</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (physiopathology)</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Carbidopa</term>
<term>Levodopa</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Fatigue</term>
</keywords>
<keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Brain</term>
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<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Double-Blind Method</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background:</title>
<p>Fatigue is a common complaint in Parkinson disease (PD). We investigated fatigue in a cohort of previously untreated patients with early PD enrolled in the Earlier vs Later Levodopa (ELLDOPA) clinical trial.</p>
</sec>
<sec><title>Methods:</title>
<p>A total of 361 patients were enrolled in the randomized, double-blind, placebo-controlled ELLDOPA trial and assigned to receive placebo or carbidopa-levodopa 37.5/150 mg, 75/300 mg, or 150/600 mg daily for 40 weeks, followed by a 2-week medication washout period. Subjects who scored >4 on the Fatigue Severity Scale were classified as fatigued. PD severity was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr scale, and Schwab-England Activities of Daily Living Scale. A subgroup of subjects underwent [<sup>123</sup>
I]-β-CIT SPECT to measure striatal dopamine transporter density.</p>
</sec>
<sec><title>Results:</title>
<p>Of the 349 ELLDOPA subjects who completed fatigue measures, 128 were classified as fatigued at baseline. The fatigued group was significantly more impaired neurologically (UPDRS, all subscales and Hoehn and Yahr staging) and functionally (Schwab-England Scale) but no significant differences were observed in β-CIT measurements between the two groups. Analysis of covariance showed a greater increase in fatigue score from baseline to the end of the 2-week washout in the placebo group (0.75 points) than in the three groups receiving levodopa (increases of 0.30 [150 mg/day], 0.36 [300 mg/day], and 0.33 [600 mg/day]; <italic>p</italic>
 = 0.03 for heterogeneity).</p>
</sec>
<sec><title>Conclusions:</title>
<p>Fatigue is a frequent symptom in early, untreated, non-depressed patients with Parkinson disease (PD), affecting over 1/3 of the patients in this cohort at baseline and 50% by week 42. Fatigue was associated with the severity of PD, and progressed less in patients treated with levodopa.</p>
</sec>
<sec><title>GLOSSARY</title>
<def-list list-type="abr"><def-item><term><bold>ELLDOPA</bold>
</term>
<def><p> = Earlier vs Later Levodopa; </p>
</def>
</def-item>
<def-item><term><bold>FSS</bold>
</term>
<def><p> = Fatigue Severity Scale; </p>
</def>
</def-item>
<def-item><term><bold>Ham-D</bold>
</term>
<def><p> = Hamilton Depression Scale; </p>
</def>
</def-item>
<def-item><term><bold>PD</bold>
</term>
<def><p> = Parkinson disease; </p>
</def>
</def-item>
<def-item><term><bold>UPDRS</bold>
</term>
<def><p> = Unified Parkinson's Disease Rating Scale.</p>
</def>
</def-item>
</def-list>
</sec>
</div>
</front>
</TEI>
</record>

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Fatigue in levodopa-naïve subjects with Parkinson disease

Fatigue in levodopa-naïve subjects with Parkinson disease

Source :

English descriptors

Abstract

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Links to Exploration step

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