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HOPE for FATIGUE

Fatigue: The Silent Symptom of Parkinson’s Disease

A 2013 survey by the Parkinson’s disease Foundation (PDF) identified fatigue as the most pressing need for the Parkinson’s research community.

While tremors, muscle stiffness, and irregular gait are the symptoms most associated with Parkinson’s disease, 50% of PD patients experience severe fatigue and a third say it is their single most debilitating symptom. Fatigue is the most significant reason cited for medical disability insurance claims by PD patients in the United States. Despite this overwhelming evidence, neurologists tend not to recognize fatigue as a prominent concern of PD patients.

Two studies in newly diagnosed Parkinson’s patients reported fatigue to be a clinically relevant problem even when motor symptoms were minimal. These studies identified fatigue as a “pre-motor” symptom, appearing well before motor symptoms become obvious. Parkinson’s patients describe their fatigue as different than any tiredness they had experienced before their diagnosis. Unlike fatigue in the general public, PD fatigue often improves with exercise.

Mental fatigue that affects Parkinson’s patients is called “central fatigue” and relates to the experience of feeling weary or exhausted during an intellectually challenging task, along with decreased capacity to initiate or sustain cognitively challenging activities. Parkinson’s patients suffering from cognitive fatigue have reduced attention span, and may have deficits in learning, memory, and information processing. Cognitive fatigue will often emerge as tasks become increasingly more complex or attention demands are greater.

Causes of PD Fatigue

The cause of fatigue in Parkinson’s disease is still elusive, though researchers speculate it may be due to changes that take place in the brain. Recently, researchers have found that Parkinson’s patients with fatigue had significantly lower serotonin transporter binding than patients without fatigue in the basal ganglia and limbic structures of the brain. Other causes of PD fatigue under investigation include peripheral inflammation and immune activation, and mitochondrial dysfunction.

Depression, sleep disturbances, and medications may also contribute to or cause fatigue. However, Dr. Joseph Friedman, Professor and Chief of the Division of Movement Disorders at the Warren Alpert Medical School of Brown University, points out that while fatigue is an early symptom and may be associated with depression, most PD patients with fatigue are not depressed.

Clinicians and researchers use rating scales for diagnosing the existence and severity of PD fatigue. Some scales, such as the Modified Fatigue Impact Scale, evaluate cognitive, as well as physical and social function. While most of these tests evaluate fatigue on a subjective level, objective measures for cognitive function exist that can measure performance changes during mental tasks.

Treatment Approaches

Currently, there are no effective treatments for PD fatigue. Clinicians often encourage patients to exercise, practice good sleep habits, take naps, keep mentally active, increase the intake of fiber and drink plenty of water. 

While few medications have proven to be helpful, methylphenidate, a pharmaceutical stimulant, was shown to be effective in lowering fatigue scores in patients with PD in a 6-week treatment period. This medication is often prescribed off label in clinical practice to help combat the effect of debilitating fatigue in PD patients.

In order to offer better treatment options, clear standards to measure and define fatigue in Parkinson’s disease are necessary. Research is also needed to identify biomarkers that can better diagnose and evaluate fatigue treatments. Using a range of brain imaging techniques to examine the underlying biology of fatigue, including the role of inflammation, could help identify changes in the brain associated with fatigue. Lastly, studying the effectiveness of non-drug therapies such as mindfulness-based stress reduction and energy management strategies (pacing), may be helpful. These non-drug therapies have been shown to also be helpful to patients with fatigue due to Multiple Sclerosis.

14 comments

  • logan33d
    logan33d Monday, 23 October 2017 01:25 Comment Link

    Logan Caleb
    I am a 66-years-old man. My Parkinson's disease appeared at the age of 37. My symptoms, at the beginning, were fine tremors and rigidity with joint stiffness. I was taking entacapone with levodopa, carbidopa, and pramipexole. My Parkinson's disease is mostly under control but not cured,After using Parkinson's disease herbal formula my daughter purchased online from Good Health Herbs Home,my parkinson's diseases disappeared,Am living Parkinson's disease free for 6 months now,no more tremors and rigidity with joint stiffness,all thanks to Good Health Herbs Home.For more detail,visit their website www .goodhealthherbshome .com

  • Erik Coley
    Erik Coley Thursday, 19 October 2017 06:12 Comment Link

    I am Erik Coley i was diagnosed of parkinson disease, i had severe calf pain, slurred speech, muscle pain and so many other pains. I was placed on sinemet 3 times daily, it helped me but not very much so our doctor introduced me to Standard Herbs Home with whome i purchased herbal remedy from and now i am parkinson disease free, thanks to Sandard Herbs Home and i made a promise that i will continue to tell the world how your good herbal remedy cured my parkinson disease, if you have similar problem or any type of disease i will advice you to vist Standard Herbs Home Offcial website: http://www.standardherbshome.com or contact info@standardherbshome.com

  • Jones Smith
    Jones Smith Tuesday, 05 September 2017 17:37 Comment Link

    My mother has had Parkinson for about 15 years and increasing dementia for half those years. She was in a nursing home December 2016, in bed or a wheel chair, very frail, confused and barely able to speak but, over the years, she's broken both hips and had a number of strokes so she has other health issues on top of the Parkinson was so desperate to bring my mother back to normal life,everyday of my life am always on internet searching for possible cure,one day i came across a health forum,so many people post testimony about (GENERAL HERBAL HEALTH CENTER) medicine home,the post was about Parkinson diseases cure,at first i dont believe,but i love my mother so much,i feel so bad seeing her go through pain,so i decided to give it a try,then i emailed them on generalhealthcenter1@gmail.com they replied me with a email full of joy,telling me that my mother will be cured with 8-10 weeks of usage,so i purchased the herbal medicine,and it was shipped to my home address,when i received the herbal medicine,i used it on my mother as prescribed,i was like a miracle after 8 weeks of usage my mother was able to speak,both hips was healed, it may sound like a witches’ brew, but these compounds could provide treatments for diseases that have so far foiled western doctors, such as Parkinson’s contact them on their email generalhealthcenter1gmail.com or visit their website for more info:

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  • riley aria
    riley aria Tuesday, 05 September 2017 02:10 Comment Link

    There is a breakthrough Parkinson(PD) precursor that i use in getting rid of my PD disease with great benefits. Not sure if I am allowed to share a link via this blog. Anyhow take a look at this if you are able to. If it resonates with you & if you would like more info, I'm happy to oblige,because i really know how much this online store helped my cure my Parkinson disease(PD)this natural product do cure you within few weeks ,actually never thought this would work until i give a try that is what i need from you patients suffering for PD you all really need this.
    totalcureherbalfoundation gmail com

  • riley aria
    riley aria Tuesday, 05 September 2017 02:09 Comment Link

    There is a breakthrough Parkinson(PD) precursor that i use in getting rid of my PD disease with great benefits. Not sure if I am allowed to share a link via this blog. Anyhow take a look at this if you are able to. If it resonates with you & if you would like more info, I'm happy to oblige,because i really know how much this online store helped my cure my Parkinson disease(PD)this natural product do cure you within few weeks ,actually never thought this would work until i give a try that is what i need from you patients suffering for PD you all really need this.
    totalcureherbalfoundation@gmail.com
    https://totalcureherbalfou.wixsite.com/website

  • sarah
    sarah Tuesday, 29 August 2017 00:50 Comment Link

    This is my testimony about the good work of a doctor Anthony who cured me..my names is sarah ,i was Parkinson's positive for 2 years and my mom was diagnosed of hepatitis b,,i was so desperate to get my mom back to normal ,and myself ,i was not able to get cured, till one day i saw someone post about perfect health natural herbs medicine who cured him ,so i contacted them so after 30days of usage,we went for medical check up my family doctor confirmed thats my mom was totally cured hepatitis b and i was totally cured of parkinson (PD) too,now am fully cured .thanks to dr Anthony may God keep blessing your hand work ........
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    perfecthealthnaturalherbs@gmail.com

  • Juliana
    Juliana Tuesday, 15 August 2017 06:58 Comment Link

    My husband is 80 years and has been suffering from PD for the past 15 years. Lately he started hallucinating and I didn't know how to handle the situation. He cannot sleep and tried to find and catch the imaginary people who he thinks are real. he was taken Entacapone with Levodopa, Carbidopa, and Pramipexole and started physical therapy to strengthen muscles. nothing was really working to help his condition.I took him off the Siferol (with the doctor’s knowledge) and started him on parkinson’s herbal formula i ordered from Health Herbal Clinic, his symptoms totally declined over a 5 weeks use of the Parkinsons disease natural herbal formula.i read reviews from other previous patients who used the herbal formula, my husband is now active, he can now go about daily exercise!! his symptoms so much reduced that now I hardly notice them.Visit there website www. healthherbalclinic. net or email Info@ healthherbalclinic. net

  • joelkurtis
    joelkurtis Thursday, 10 August 2017 20:37 Comment Link

    I am from Nevada, USA.. I started on NewLife Clinic Parkinsons Disease Herbal formula treatment in September 2016, i read alot of positive reviews on their success rate treating Parkinsons disease through their PD Herbal formula and i immediately started on the treatment. Just 11 weeks into the Herbal formula treatment I had great improvements with speech and coordination, my hand tremors seized and the stiffed, rigid muscle had succumbed. I am unbelievably back on my feet again, this is a breakthrough for all Parkinsons sufferers, visit NewLife Herbal Clinic official website www. newlifeherbalclinic. com or email info@ newlifeherbalclinic. com.




    Joel Kurtis
    Nevada, USA

  • hayes paul
    hayes paul Monday, 31 July 2017 11:13 Comment Link

    One faithful day on the internet I saw some post's about naturalherbscenter,so many people was talking about their herbal medicine that they cures different kinds of deadly diseases,so i decided to give it a try ,i contacted them via their email,(naturalherbalcenter@outlook.com) website;(http://naturalherbscenter.simplesite.com),so they replied me,and told me that they will cure me within 5-6 weeks

  • Donnie
    Donnie Tuesday, 18 July 2017 00:40 Comment Link

    My husband is 80 years and has been suffering from PD for the past 15 years. Lately he started hallucinating and I didn't know how to handle the situation. He cannot sleep and tried to find and catch the imaginary people who he thinks are real. he was taken Entacapone with Levodopa, Carbidopa, and Pramipexole and started physical therapy to strengthen muscles. nothing was really working to help his condition.I took him off the Siferol (with the doctor’s knowledge) and started him on parkinson’s herbal formula i ordered from Health Herbal Clinic, his symptoms totally declined over a 5 weeks use of the Parkinsons disease natural herbal formula.i read reviews from other previous patients who used the herbal formula, my husband is now active, he can now go about daily exercise!! his symptoms so much reduced that now I hardly notice them.Visit there website www. healthherbalclinicc. weebly. com or email Info@ healthherbalclinic. net

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