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Open Access 20-05-2023 | Parkinson's Disease | Neurology and Preclinical Neurological Studies - Original Article

Fatigue in fluctuating Parkinson’s disease patients: possible impact of safinamide

Authors: Caterina Pauletti, Nicoletta Locuratolo, Daniela Mannarelli, Andrea Maffucci, Alessia Petritis, Elisa Menini, Francesco Fattapposta

Published in: Journal of Neural Transmission | Issue 7/2023

Abstract

Fatigue is a common non-motor symptom in Parkinson’s disease (PD). Among other pathophysiological mechanisms, neuroinflammation, a pathological PD hallmark associated with changes in glutamatergic transmission in basal ganglia, has been proposed as a crucial factor closely related to fatigue. To test the hypothesis that safinamide could represent an effective treatment of fatigue in PD patients, given its dual mechanism of action (it selectively and reversibly inhibits MAOB and modulates glutamate release), we administered the validated versions of fatigue severity scale (FSS) and Parkinson fatigue scale-16 (PFS-16) to 39 fluctuating PD patients with fatigue before and after a 24-week treatment period with safinamide as add-on therapy. An assessment of secondary variables such as depression, quality of life (QoL), and motor and non-motor symptoms (NMS) was conducted. After 24 weeks of treatment with safinamide, both FSS (p < 0.001) and PF-S16 (p = 0.02) scores were significantly lower than at baseline. Moreover, 46.2% and 41% of patients scored below the cut-off for the presence of fatigue according to FSS and PFS-16, respectively (responders). At follow-up, a significant difference emerged between responders and non-responders in mood, QoL, and NMS. Fatigue improved in fluctuating PD, and more than 40% of patients were “fatigue-free” after a 6 month treatment with safinamide. Patients without fatigue at follow-up displayed significantly better scores in QoL domains, such as mobility or activities of daily living, although disease severity remained stable, supporting the hypothesis that fatigue could considerably affect QoL. Drugs that interact with multiple neurotransmission systems, such as safinamide, could be useful in reducing this symptom.

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Title: Fatigue in fluctuating Parkinson’s disease patients: possible impact of safinamide
Authors: Caterina Pauletti
Nicoletta Locuratolo
Daniela Mannarelli
Andrea Maffucci
Alessia Petritis
Elisa Menini
Francesco Fattapposta
Publication date: 20-05-2023
Publisher: Springer Vienna
Keywords: Parkinson's Disease
Safinamide
Fatigue
Published in: Journal of Neural Transmission / Issue 7/2023
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-023-02654-1

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Fatigue in fluctuating Parkinson’s disease patients: possible impact of safinamide

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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