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Cited by 78Parkinson's Disease Mechanisms and TreatmentsNeurological disorders and treatmentsTranscranial Magnetic Stimulation Studies

The Pathophysiology of Fatigue in Parkinson's Disease and its Pragmatic Management

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Kostić, Vladimir S., Tomić, Aleksandra, Ječmenica‐Lukić, Milica·2016·Movement Disorders Clinical Practice
DOI 10.1002/mdc3.12343PMC PMC6178705
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Abstract

Background: Fatigue is 1 of the most common and most disabling symptoms among patients with Parkinson's disease ( PD ) and has a significant impact on their quality of life. Yet the pathophysiology of fatigue is poorly understood, while its treatment is “limited to an empirical approach based on plausible hypotheses.” Methods: PubMed was searched for articles with the key words “Parkinson's disease” or “parkinsonism” and “fatigue” that were published by or before August 2015. The analysis of articles, which were selected on subjective grounds, was used to review the current knowledge of pathophysiology and treatment outcomes in studies focused on fatigue in PD . Conclusions: Clinical and experimental findings support the view that fatigue is a primary manifestation of PD . The main hypothesized pathophysiological mechanisms include abnormal basal ganglia ( BG )‐cortical mechanisms, particularly frontal loops, and an imbalance between neurotransmitters (e.g., dopamine [ DA ] and serotonin), along with an altered hypothalamus‐pituitary‐adrenal axis, neuroinflammation, cardiac sympathetic denervation, etc. Pragmatic treatment of fatigue in patients with PD includes various pharmacological (dopaminergic and psychostimulant drugs, antidepressants) and nonpharmacological strategies, although current knowledge suffers from insufficient evidence to support the use of any drug or nondrug therapy.

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Cited by

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Authors
Kostić, V. S., Tomić, A., & Ječmenica‐Lukić, M.
Affiliations
University of Belgrade (RS)
Corresponding author
Kostić, Vladimir S.
ORCID
Venue
Movement Disorders Clinical Practice
Publisher
Wiley
Published
2016-03-11
Volume
3
Issue
4
Pages
323-330
ISSN
2330-1619 (ISSN-L)
DOI
10.1002/mdc3.12343
PMC
PMC6178705
OpenAlex
W2314210898
Cited by
78
References
1
Citations by year
2026: 16 · 2025: 8 · 2024: 12 · 2023: 12 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 2 · 2018: 2 · 2017: 2
FWCI
0.28
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Movement Disorders Clinical Practice (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Ministry of Education and Science, Republic of Serbia (175090)
Topics
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
fatigue, Parkinson's disease, pathophysiology, dopamine, serotonin, hypothalamic-pituitary-adrenal axis, neuroinflammation, cardiac sympathetic denervation, dopaminergic therapy, psychostimulants, antidepressants, non-pharmacological treatment, quality of life

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