[Inflammatory mechanisms of fatigue syndrome in Parkinson's disease].

OBJECTIVE: To study clinical characteristics of fatigue syndrome in patients with Parkinson's disease (PD) and a role of inflammation in its development. MATERIAL AND METHODS: We examined 98 patients with confirmed diagnosis of PD and 18 healthy people. Clinical examination included an analysis of anamnesis and objective somatic symptoms. The unified Parkinson's disease rating scale, The Hoehn and Yahr scale, the Multidimensional Fatigue Inventory (MFI-20) scale, the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS), The Epworth Sleepiness Scale (ESS), Vein's Autonomic Symptoms Questionnaire (VASQ) were used for quantitative assessment. Serum concentrations of IL-6 were measured in 65 patients and 18 controls using ELISA. RESULTS AND CONCLUSION: In PD patients, fatigue assessed with MFI-20 was recorded in 46 (47%) cases and fatigue as assessed with MFIS in 45 (46%) of cases. High frequency and severity of fatigue syndrome were observed. The most prominent components in the structure of fatigue were physical fatigue, reduced motivation and decreased activity. Signs of fatigue increased with disease progression. Correlation between fatigue and axial motor symptoms of PD is of interest. Patients had higher serum IL-6 levels compared to the controls. Concentrations of IL-6 were correlated with fatigue severity and its main components (general and physical fatigue, decreased activity) and with depression level.

[Correction of motor and affective symptoms of parkinsonism by selective serotonine reuptake inhibition antidepressant].

A study included 68 patients with parkinsonism: 43 of them were treated with proflusak (fluoxetin), which efficacy was assessed in the frames of randomized placebo-controlled study. The levels of motor disability, anxiety, depression and serum serotonin (S) concentration were measured. The prevalence of rigidity and hypokinesia caused the increase of the depression level, along with decreasing of S concentration. Severity of tremor was positively correlated with the level of anxiety and blood S. Significant differences between patients receiving proflusak and placebo were found. No changes in the levels of motor-affective symptoms were observed in the placebo group. In patients treated with proflusak, the subjective improvement of health was accompanied by the significant decrease of depression severity and reduction of movement deficit, in particular rigidity and hypokinesia. The blood concentration of S decreased significantly in comparison to the placebo group. Taking into account the mechanism of action of the drug studied (its belonging to SSRIs), these changes may reflect the alterations of serotonergic metabolism in the brain synapses.