Fatigue in Early Parkinson Disease

Fatigue can be a disabling symptom in patients with Parkinson disease (PD), but the pathogenesis of fatigue in PD is unknown. The authors examined fatigue in levodopa-naive patients in the Earlier versus Later Levodopa (ELLDOPA) trial (see JW Neurol 2006 Mar 9). In this trial, the researchers had randomized 361 patients with PD to receive placebo or carbidopa–levodopa at three different doses for 40 weeks, followed by a 2-week washout period. Subjects were evaluated on the Fatigue Severity Scale (FSS) at baseline and weeks 3, 9, 24, 40, and 42; those who scored more than 4 (out of 7) were classified as fatigued. In an imaging substudy, 131 participants underwent [¹²³I]-β-CIT single-photon emission computed tomography to measure striatal dop…