Galli Silvia, Pacilio Pierre, Bianchini Edoardo, Alborghetti Marika, De Carolis Lanfranco, Lombardo Pietro, Garramone Francesco, Salvetti Marco, Rinaldi Domiziana
Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Via di Grottarossa, 1035, 00189 Rome, Italy.
AGEIS (Autonomy, Gerontology, E-Health, Imaging & Society Unité de Recherche), Université Grenoble Alpes, 38000 Grenoble, France.
J Clin Med. 2025 Apr 10;14(8):2598. doi: 10.3390/jcm14082598.
Fatigue is a common and debilitating non-motor symptom (NMS) in Parkinson's disease (PD), significantly affecting patients' quality of life. MAO-B inhibitors are effective therapy for motor symptoms and fluctuations and may also play a role in fatigue management. We searched PubMed for English-language articles (January 1978-August 2024) using keywords including "selegiline", "rasagiline", "safinamide", "MAO-B", "fatigue", and "Parkinson's disease". Clinical trials, observational, and preclinical studies were included. While the role of MAO-B inhibitors in fatigue remains unclear, evidence suggests potential benefits. Selegiline has shown effectiveness in improving fatigue in animal models, supporting its potential utility in treating fatigue and motivational impairments in PD patients. Rasagiline has been associated with reduced fatigue progression in early PD, with some studies showing significant improvements compared to placebo. Safinamide, with its dual action as an MAO-B inhibitor and glutamate modulator, may further enhance fatigue management. Its ability to reduce glutamate release is particularly relevant, given the role of glutamate overactivity in PD-related fatigue. Studies indicate safinamide can significantly reduce fatigue levels. Fatigue in PD is a complex symptom with multiple contributing factors. While MAO-B inhibitors may support fatigue management, their precise role and optimal use require further investigation.
疲劳是帕金森病（PD）常见且使人衰弱的非运动症状（NMS），严重影响患者的生活质量。单胺氧化酶B（MAO-B）抑制剂是治疗运动症状及症状波动的有效疗法，在疲劳管理中可能也发挥作用。我们在PubMed上搜索了1978年1月至2024年8月期间的英文文章，使用的关键词包括“司来吉兰”“雷沙吉兰”“沙芬酰胺”“MAO-B”“疲劳”和“帕金森病”。纳入了临床试验、观察性研究和临床前研究。虽然MAO-B抑制剂在疲劳方面的作用仍不明确，但有证据表明其具有潜在益处。司来吉兰在动物模型中已显示出改善疲劳的效果，支持其在治疗PD患者疲劳和动机障碍方面的潜在效用。雷沙吉兰与早期PD患者疲劳进展减缓有关，一些研究表明与安慰剂相比有显著改善。沙芬酰胺作为MAO-B抑制剂和谷氨酸调节剂具有双重作用，可能会进一步加强疲劳管理。鉴于谷氨酸活性过高在PD相关疲劳中的作用，其降低谷氨酸释放的能力尤为重要。研究表明沙芬酰胺可显著降低疲劳水平。PD中的疲劳是一种复杂的症状，有多种促成因素。虽然MAO-B抑制剂可能有助于疲劳管理，但其确切作用和最佳用法仍需进一步研究。
