Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Division of Human Anatomy - Neuronal Networks Morphology Lab, University of Campania "Luigi Vanvitelli", Naples, Italy; I Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Parkinsonism Relat Disord. 2021 May;86:114-123. doi: 10.1016/j.parkreldis.2021.03.018. Epub 2021 Mar 29.
The emerging science of fatigue has soundly endorsed the need for its unified definition, shared terminology and increased recognition in neurological illnesses. Nevertheless, the real impact of fatigue remains under-recognized. Fatigue describes a sense of tiredness, lack of energy or need for increased effort often perceived as overwhelming, pervasive, and disabling. It is a common feature of chronic medical conditions and neurological diseases, including Parkinson's disease (PD) and other hypokinetic, hyperkinetic, and functional movement disorders (FMD). While there is solid evidence for the burden of fatigue in PD, knowledge of fatigue in other movement disorders (MDS) is still limited. Lack of consensus definition, rigorous measures and the high prevalence of potential confounders such as apathy, depression and sleepiness are the main obstacles in studying fatigue in MDS. This review of the prevalence, impact, and clinical correlates of fatigue in common MDS summarizes current hypotheses for the pathophysiological mechanisms underlying fatigue and gives a brief overview of treatment options. Fatigue is a prevalent, disabling, primary non-motor symptom (NMS) in MDS, including atypical and secondary parkinsonisms, dystonia, essential tremor (ET) and a hallmark feature of FMD. We report the hypothesis that fatigue is a perceptual disorder of the sensorimotor system. Given the relevance of this burdensome symptom, fatigue deserves greater clinical and research attention to better understand its manifestation and pathophysiology and to improve diagnosis and treatment.
疲劳的新兴科学充分证明了需要对其进行统一定义、共享术语，并在神经疾病中得到更多认可。然而，疲劳的真正影响仍然未被充分认识。疲劳描述了一种疲倦感、缺乏能量或需要增加努力的感觉，通常被认为是压倒性的、普遍存在的和使人丧失能力的。它是慢性医学病症和神经疾病的常见特征，包括帕金森病（PD）和其他运动减少、运动过度和功能性运动障碍（FMD）。虽然有确凿的证据表明 PD 患者的疲劳负担，但对其他运动障碍（MDS）的疲劳的了解仍然有限。缺乏共识定义、严格的测量方法以及潜在混杂因素（如冷漠、抑郁和嗜睡）的高患病率是研究 MDS 中疲劳的主要障碍。本文综述了常见 MDS 中疲劳的患病率、影响和临床相关性，总结了疲劳的病理生理机制的当前假说，并简要概述了治疗选择。疲劳是 MDS 中普遍存在的、使人丧失能力的原发性非运动症状（NMS），包括非典型和继发性帕金森病、肌张力障碍、特发性震颤（ET）和 FMD 的标志性特征。我们提出了一个假设，即疲劳是一种感觉运动系统的知觉障碍。鉴于这种负担沉重的症状的相关性，疲劳值得更多的临床和研究关注，以更好地理解其表现和病理生理学，并改善诊断和治疗。
