Journal of Neural Transmission

, Volume 124, Issue 3, pp 335–345 | Cite as

Attention in Parkinson’s disease with fatigue: evidence from the attention network test

  • Caterina Pauletti
  • Daniela Mannarelli
  • Nicoletta Locuratolo
  • Luca Pollini
  • Antonio Currà
  • Lucio Marinelli
  • Steno Rinalduzzi
  • Francesco Fattapposta
Neurology and Preclinical Neurological Studies - Original Article


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.


Attention Parkinson’s disease Fatigue Reaction time Attention network test 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Department of Neurology and PsychiatrySapienza University of RomeRomeItaly
  2. 2.Vaclav Vojta Rehabilitation CenterRomeItaly
  3. 3.Academic Neurologic Unit, A. Fiorini HospitalSapienza University of RomeTerracina, LTItaly
  4. 4.Department of Neurosciences Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), Institute of NeurologyUniversity of GenovaGenovaItaly
  5. 5.Neurology and Neurophysiopathology UnitSandro Pertini HospitalRomeItaly

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