Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Eur J Neurol. 2022 Sep;29(9):2631-2638. doi: 10.1111/ene.15411. Epub 2022 Jun 6.
Although disabling fatigue is common in Parkinson disease (PD), available consensus-based diagnostic criteria have not yet been empirically validated. The aim of this study was to evaluate the clinimetric properties of the criteria.
A sample of outpatients with PD was evaluated for demographic, clinical, behavioral, and cognitive features. Fatigue was diagnosed according to the new diagnostic criteria and was rated by means of the Parkinson Fatigue Scale (PFS) and Fatigue Severity Scale (FSS). Acceptability, concurrent and discriminant validity, and interrater reliability were evaluated with binary logistic regression analyses and Cohen kappa (κ).
Of 241 included patients, 17 (7.1%) met the diagnostic criteria for PD-related fatigue. Eight of nine symptoms described in Section A of the diagnostic criteria occurred in >50% of patients with fatigue. Acceptability (missing data = 0.8%) of the criteria was good, as was their concurrent validity with the PFS (odds ratio = 3.65) and FSS (odds ratio = 3.63). The discriminant validity of fatigue criteria with other PD-related behavioral and cognitive features was good (odds ratio < 1.68). The interrater reliability was excellent (κ = 0.92).
This is the first study to test the clinimetric properties of case definition diagnostic criteria for PD-related fatigue. Our results suggest that current diagnostic criteria may be useful in both clinical practice and research. Future longitudinal studies should examine their long-term stability.
虽然疲劳是帕金森病（PD）的常见症状，但现有的基于共识的诊断标准尚未经过实证验证。本研究旨在评估这些标准的临床计量学特性。
对一组 PD 门诊患者进行了人口统计学、临床、行为和认知特征的评估。根据新的诊断标准诊断疲劳，并使用帕金森疲劳量表（PFS）和疲劳严重程度量表（FSS）进行评分。使用二项逻辑回归分析和 Cohen kappa（κ）评估可接受性、同时和判别有效性以及评分者间可靠性。
在 241 名纳入的患者中，有 17 名（7.1%）符合 PD 相关疲劳的诊断标准。诊断标准 A 部分中描述的 9 个症状中有 8 个出现在≥50%的疲劳患者中。标准的可接受性（缺失数据=0.8%）良好，与 PFS（优势比=3.65）和 FSS（优势比=3.63）的同时有效性良好。疲劳标准与其他 PD 相关行为和认知特征的判别有效性良好（优势比<1.68）。评分者间可靠性极好（κ=0.92）。
这是第一项测试 PD 相关疲劳病例定义诊断标准临床计量学特性的研究。我们的结果表明，目前的诊断标准在临床实践和研究中可能都有用。未来的纵向研究应该检验它们的长期稳定性。
