Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy.
Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
Parkinsonism Relat Disord. 2021 Oct;91:135-138. doi: 10.1016/j.parkreldis.2021.09.020. Epub 2021 Sep 29.
Psychological factors can underlie fatigue in neurological disorders, but its relationship to fatigue in Parkinson's disease (PD) has not been explored. We assessed the association between maladaptive metacognitive beliefs and presence of fatigue in PD.
Ninety-eight consecutive outpatients with PD (61% male; median age: 66.50 years) were assessed in terms of demographic, clinical, medication treatment, cognitive, or behavioural characteristics including metacognitive beliefs (Metacognitions Questionnaire-30 or MCQ). Fatigue was ascertained by PD-related diagnostic criteria. Univariate statistical approach (Mann-Whitney and Pearson chi-square tests) was used to compare PD patients with (f-PD) or without (nf-PD) fatigue in terms of demographic, clinical, medication treatment, cognitive, behavioural, and metacognitive measures.
Twenty-one PD patients (21%) displayed fatigue. The f-PD group scored higher on the MCQ-total score, MCQ-Cognitive Confidence subscale, and all behavioral measures (p < 0.01) relative to nf-PD. They also had a more advanced Hoehn and Yahr stage and Unified Parkinson's Disease Rating Scale-III score.
Maladaptive metacognitive beliefs such as the lack of cognitive confidence may play a key role to trigger and maintain fatigue in PD. Future studies, using a multivariate statistical approach, are needed to confirm these preliminary findings in a larger sample of patients with fatigue and to assess if modification of such metacognitive beliefs has the potential to ameliorate fatigue in PD.
心理因素可能是神经障碍患者疲劳的根源，但在帕金森病（PD）中，其与疲劳的关系尚未得到探索。我们评估了适应不良的元认知信念与 PD 患者疲劳之间的关系。
对 98 名连续的 PD 门诊患者（61%为男性；中位年龄：66.50 岁）进行了人口统计学、临床、药物治疗、认知或行为特征（包括元认知信念[元认知问卷-30 或 MCQ]）评估。疲劳通过 PD 相关诊断标准确定。采用单变量统计方法（Mann-Whitney 和 Pearson chi-square 检验）比较了有疲劳（f-PD）和无疲劳（nf-PD）的 PD 患者在人口统计学、临床、药物治疗、认知、行为和元认知方面的差异。
21 名 PD 患者（21%）出现疲劳。与 nf-PD 相比，f-PD 组在 MCQ 总分、MCQ-认知信心分量表和所有行为测量方面的得分更高（p<0.01）。他们的 Hoehn 和 Yahr 分期和统一帕金森病评定量表-III 评分也更高。
缺乏认知信心等适应不良的元认知信念可能在触发和维持 PD 患者疲劳方面发挥关键作用。需要使用多变量统计方法的进一步研究来在更大的疲劳患者样本中验证这些初步发现，并评估此类元认知信念的改变是否有可能改善 PD 患者的疲劳。
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