Using modafinil to treat fatigue in Parkinson disease: a double-blind, placebo-controlled pilot study.
BACKGROUND
Fatigue is a major nonmotor symptom in Parkinson disease(PD). It is associated with reduced activity and lower quality of life.


OBJECTIVE
To determine if modafinil improves subjective fatigue and physical fatigability in PD.


METHODS
Nineteen PD patients who reported significant fatigue in the Multidimensional Fatigue Inventory (MFI) participated in this 8-week study. Subjects took their regular medications and were randomly assigned to the treatment group (9 subjects, modafinil 100-mg capsule BID) or placebo group (10 subjects). We used the MFI to measure subjective fatigue and used finger tapping and intermittent force generation to evaluate physical fatigability. Subjects also completed the Epworth Sleepiness Scale (ESS) and the Center of Epidemiological Study-Depression Scale.


RESULTS
There were no significant differences at baseline and at 1 month in finger tapping and ESS between the modafinil and placebo groups. At 2 months, the modafinil group had a higher tapping frequency (P<0.05), shorter dwell time (P<0.05), and less fatigability in finger tapping and tended to have lower ESS scores (P<0.12) than the placebo group. However, there was no difference between groups over time for any dimension of the MFI .


CONCLUSIONS
This small study demonstrated that although modafinil may be effective in reducing physical fatigability in PD, it did not improve fatigue symptoms.
Lou
Jau-Shin
JS
Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA. louja@ohsu.edu
Dimitrova
Diana M
DM
Park
Byung S
BS
Johnson
Sarah C
SC
Eaton
Ryan
R
Arnold
Grace
G
Nutt
John G
JG
D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004311:Double-Blind Method; D005221:Fatigue / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010865:Pilot Projects; D011597:Psychomotor Performance / Q000187:drug effects / Q000502:physiology; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013998:Time Perception / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil