title: Attention in Parkinson's disease with fatigue: evidence from the attention network test.
abstract: Fatigue is a non-specific symptom that is common in chronic diseases and represents one of the most disabling symptoms in Parkinson's disease. PD patients often experience cognitive deficits related above all to executive functions. The relationship between cognitive changes and fatigue in PD patients has not been explored in depth. The Attention Network Test (ANT) is a rapid, widely used test to measure the efficiency of three attentional networks, i.e., alerting, orienting, and executive, by evaluating reaction times (RTs) in response to visual stimuli. To assess the association between fatigue and the efficiency of the attentional networks, according to the Posnerian view, ANT was administered to 15 parkinsonian patients with fatigue (PFS-16 > 2.95), 17 parkinsonian patients without fatigue, and 37 age- and sex-matched healthy controls. Anxiety, depression, quality of sleep, and quality of life were also assessed. Parkinsonian patients displayed significantly longer RTs and lower executive network efficiency than controls. Patients with fatigue displayed significantly lower executive network efficiency than patients without fatigue. Moreover, patients with fatigue exhibited a lower accuracy than either patients without fatigue or controls. Finally, patients without fatigue displayed a more efficient alerting network than either patients with fatigue or controls. Although the pathogenesis of fatigue is multifactorial, our results indicate that fatigue may be closely related to an alteration of the striato-thalamo-cortical loop connecting the neostriatum to the prefrontal cortex, which is also responsible for the executive dysfunction that is typical of Parkinson's disease.
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. caterina.pauletti@uniroma1.it.|Vaclav Vojta Rehabilitation Center, Via Pincherle 186, 00146, Rome, Italy. caterina.pauletti@uniroma1.it.
authors: Caterina
authors: 0000-0003-3885-9921
authors: C
authors: Pauletti
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
authors: Daniela
authors: D
authors: Mannarelli
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
authors: Nicoletta
authors: N
authors: Locuratolo
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
authors: Luca
authors: L
authors: Pollini
authors: Academic Neurologic Unit, A. Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy.
authors: Antonio
authors: A
authors: Currà
authors: Department of Neurosciences Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), Institute of Neurology, University of Genova, Largo Daneo 3, 16132, Genova, Italy.
authors: Lucio
authors: L
authors: Marinelli
authors: Neurology and Neurophysiopathology Unit, Sandro Pertini Hospital, Rome, Italy.
authors: Steno
authors: S
authors: Rinalduzzi
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
authors: Francesco
authors: F
authors: Fattapposta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D005221:Fatigue / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020734:Parkinsonian Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D011930:Reaction Time
keywords: Attention; Attention network test; Fatigue; Parkinson’s disease; Reaction time