An objective measure combining physical and cognitive fatigability: Correlation with subjective fatigue in Parkinson's disease.
Objective measures of physical and cognitive fatigability do not correlate with subjective Parkinson's disease (PD)-related fatigue. The relationship of subjective PD-related fatigue to tasks combining cognitive and motor effort has never been explored.



Forty-four right-handed, non-demented PD patients, 22 with (PD-F) and 22 without (PD-NF) fatigue, were tested using a sensor-engineered glove on their more affected hand. Patients performed sequential opposition finger movements following a metronome at 2 Hz for 5 min (cued task), and for another minute following a 2-min rest. The same task was repeated without sustained auditory cueing. Movement time (inter-tapping interval, ITI) and rate, touch duration, percentage of correct sequences and clinical measures (motor and fatigue severity, depression, sleep impairment and apathy) were analysed.



In the cued task, motor performance worsened over time (significantly increased ITI and decreased movement rate on the third to fifth minute) in PD-F patients only. In the uncued task, motor performance deteriorated similarly in the two groups. PD-F and PD-NF patients differed in ITI and movement rate deterioration over time only in the cued task, independently from motor severity, depression and sleep impairment. The severity of subjective fatigue complaints significantly correlated with motor performance deterioration in the cued task.



PD-related fatigue is associated with performance on an externally cued, attention-controlled motor task, but not with an uncued version of the same task. The finding supports a link between PD-related fatigue and attention-demanding motor tasks, proposing a model of inducible fatigue applicable to future clinical and neuroimaging research.
International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK; Queen Elizabeth Hospital, Woolwich, Lewisham & Greenwich NHS Trust, London, UK. Electronic address: davidemartino@nhs.net.
Davide
D
Martino
Department of Neuroscience (DiNOGMI), University of Genoa, Genoa, Italy.
Tiziano
T
Tamburini
International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK.
Panagiotis
P
Zis
International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK.
Gavril
G
Rosoklija
Department of Neuroscience (DiNOGMI), University of Genoa, Genoa, Italy.
Giovanni
G
Abbruzzese
International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London, UK.
Kallol
K
Ray-Chaudhuri
Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy.
Elisa
E
Pelosin
Department of Neuroscience (DiNOGMI), University of Genoa, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy.
Laura
L
Avanzino
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000209:etiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003463:Cues; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009068:Movement / Q000502:physiology; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology; D010808:Physical Examination
Attention; Fatigue; Motor control; Parkinson's disease