Fatigue in Parkinson's disease: report from a mutidisciplinary symposium

Joseph H Friedman, James C Beck, Kelvin L Chou, Gracia Clark, Christopher P Fagundes, Christopher G Goetz, Karen Herlofson, Benzi Kluger, Lauren B Krupp, Anthony E Lang, Jao-Shin Lou, Laura Marsh, Anne Newbould, Daniel Weintraub, Joseph H Friedman, James C Beck, Kelvin L Chou, Gracia Clark, Christopher P Fagundes, Christopher G Goetz, Karen Herlofson, Benzi Kluger, Lauren B Krupp, Anthony E Lang, Jao-Shin Lou, Laura Marsh, Anne Newbould, Daniel Weintraub

Abstract

Fatigue is a severe problem for many people living with Parkinson's disease (PD). Best estimates suggest that more than 50% of patients experience this debilitating symptom. Little is known about its etiology or treatment, making the understanding of fatigue a true unmet need. As part of the Parkinson's Disease Foundation Community Choice Research Program, patients, caregivers, and scientists attended a symposium on fatigue on 16 and 17 October 2014. We present a summary of that meeting, reviewing what is known about the diagnosis and treatment of fatigue, its physiology, and what we might learn from multiple sclerosis (MS), depression, and cancer-disorders in which fatigue figures prominently too. We conclude with focused recommendations to enhance our understanding and treatment of this prominent problem in PD.

Conflict of interest statement

JHF: Teva, Auspex, Osmotica, Acadia, Lundbeck, Avid, Medscape, Theravance. KLC has received research support from the NIH (NS44504-08, NS091856-01) and the Michael J. Fox Foundation, has participated as a site-PI in clinical trials sponsored by the Huntington Study Group (2CARE) and Osmotica, receives royalties from UpToDate and Demos Health and serves as a consultant for Medtronic and Accordant. CGG: Consulting or Advisory Board Membership with honoraria from Acadia (Deborah Wood Associates), AstraZeneca, Avanir, Boston Scientific, Clearview, Health Advances, Chelsea Pharmaceuticals (Link Medical Communications), ICON Pricespective LLC, MED-IQ Educational Services, Neurocrine, Pfizer, Teva, and WPP Group Kantor Health LLC. He recieves funding from NIH and Michael J Fox Foundation. CGG directs the Rush Parkinson’s Disease Research Center that receives support from the Parkinson’s Disease Foundation. He directs the translation program for the MDS-UPDRS and UDysRS and receives funds from the International Parkinson and Movement Disorder Society (IPMDS) for this effort. He receives honoraria from the University of California, University of Luxembourg, University of Rochester, World Parkinson Coalition. He has Royalties of Oxford University Press, Elsevier Publishers, Wolters Kluwer Health-Lippincott, and Wilkins and Wilkins, and receives salary from the Rush University Medical Center. KH: Allergan, Abbvie, Novartis. LBK: Johnson and Johnson; Bristol Myers Squibb. AEL has served as an advisor for Abbvie, Allon Therapeutics, Avanir Pharmaceuticals, Biogen Idec, Boerhinger-Ingelheim, Bristol Myers Squibb, Ceregene, Cipla, Intekrin, Lilly, Medtronic, Merck, Novartis, NeuroPhage Pharmaceuticals, Teva, and UCB; received honoraria from Medtronic, Teva, UCB, and AbbVie; received grants from Brain Canada, Canadian Institutes of Health Research, Edmond J Safra Philanthropic Foundation, Michael J. Fox Foundation, the Ontario Brain Institute, National Parkinson Foundation, Parkinson Society Canada, Physicians Services Incorporated (PSI), Tourette Syndrome Association, and W. Garfield Weston Foundation; received publishing royalties from Saunders, Wiley-Blackwell, Johns Hopkins Press, and Cambridge University Press; and has served as an expert witness in cases related to the welding industry. DW: receives research funding or support from Michael J. Fox Foundation for Parkinson’s Research, National Institutes of Health, Novartis Pharmaceuticals, Department of Veterans Affairs, Avid Radiopharmaceuticals, and Alzheimer’s Disease Cooperative Study; honoraria from AbbVie, Biotie, Teva Pharmaceuticals, Otsuka, UCB, Clintrex LLC, and the CHDI Foundation; license-fee payments from the University of Pennsylvania for the QUIP and QUIP-RS; royalties from Wolters Kluweland; and fees for legal consultation for lawsuit related to antipsychotic prescribing in a patient with Parkinson’s disease. The remaining authors declare no conflict of interest.

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