Does fatigue in Parkinson’s disease correlate with autonomic nervous system dysfunction?

Enrica Olivola, Livia Brusa, Camilla Rocchi, Orazio Schillaci, Claudio Liguori, Rocco Cerroni, Mariangela Pierantozzi, Agostino Chiaravalloti, Alessandro Stefani, Fabrizio Stocchi

Research output: Contribution to journalArticlepeer-review


Background: Despite its negative impact on quality of life, fatigue in Parkinson’s disease (PD) remains an under-recognized issue and the underlying pathology is undetermined. Objective: To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients. Methods: In a Caucasian population of PD patients (n = 27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests. Results: PFS-16 score correlated with disease duration (R = 0.57, p = 0.002). Fatigue showed a clear correlation with deep breathing test (R = − 0.53, p = 0.004) but not with the MIBG H/M ratios. Conclusions: Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.
Original languageEnglish
Pages (from-to)2169-2174
Number of pages6
JournalNeurological Sciences
Issue number12
Publication statusPublished - Dec 1 2018


  • Autonomic nervous system
  • Fatigue
  • Myocardial scintigraphy
  • Parkinson’s disease


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