The precise mechanisms that cause fatigue are still not understood, but
research suggests that any generalised neurological disorder which involves the
basal ganglia in
the brain is likely to be associated with significant fatigue. This includes Parkinson’s disease. There is also some evidence to suggest that
the parts of the brain involved in Parkinson’s are involved in fatigue in other
conditions.
In some cases anti-Parkinsonian medication may be a factor, for example
dopaminergic medications may affect sleep and so add to fatigue.
In
people who experience
tremor,
rigidity and
dyskinesia, the muscles themselves have to work harder in order to carry out
simple movements or tasks and this may in itself cause some degree of
fatigue.
Bradykinesia or slowness of
movement may also increase fatigue by making activities and tasks more prolonged. In
other words, activities in Parkinson’s require greater energy than normal and
so are likely to lead to greater fatigue.
As a result of Parkinson’s symptoms, people with the condition
generally spend less time on leisure activities and if they stop participating
in active leisure pursuits and sports this inevitably leads to degrees of
unfitness and with unfitness comes fatigue, so it can be a vicious circle.
It is also recognised that people with Parkinson’s often have sleep
problems for a variety of reasons and poor quality sleep tends to lead to
excessive day-time sleepiness and a tendency to ‘nap’. Although sleepiness is a separate symptom to
fatigue, it clearly adds to the problem and fatigue cannot readily be overcome
if a person is also experiencing sleepiness.
The majority of people with Parkinson’s will at some time go through
phases of depression and with depression there is usually also fatigue, loss of
motivation, a general lack of interest and difficulty in sleeping. It is important that these symptoms are recognised
as they are very treatable, and overcoming them can reduce the tendency to
fatigue.
The effect of fatigue on quality of life is usually clear to see:
- mental and physical fatigue can affect
psychological and emotional wellbeing
- the person who is fatigued may become less active
and unable to pursue hobbies and interests
- social activity requires energy, so a person with
fatigue will have a greater tendency to become withdrawn
- a reduced inclination to engage in activities is
likely to bring with it reduced stamina, reduced fitness and further muscle
weakness.
For all these reasons it is important for people with fatigue to try
and keep as active as possible. One
leading neurologist advises that anyone newly diagnosed with Parkinson’s that
they have no restrictions and should encourage their relatives to prevent them
from becoming less active to reduce the risk of experiencing fatigue and other
symptoms.
