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Overall, the meta\u2010analysis showed a prevalence of fatigue of 50% in PD. This prevalence estimate, however, was significantly moderated by study heterogeneity in measurement scales and cut\u2010off thresholds. In contrast, demographic features, disease severity, cognitive impairment, and depression did not moderate prevalence estimates. Moreover, fatigue prevalence did not differ between de novo and treated PD patients. Compared to nonfatigued patients, fatigued patients had sligthly higher age (1.44 years), disease duration (0.93 years), <jats:sc>l<\/jats:sc>\u2010dopa equivalent daily dose (50.89 units), UPDRS\u2010III (4.99 points), and H &amp; Y (0.33 points), as well as risk of comorbid depression (risk ratio\u2009=\u20091.89) and had a little lower MMSE score (\u20130.66 points). Fatigue was moderately associated with apathy (Hedges' g\u2009=\u20090.55), anxiety (Hedges' g\u2009=\u20090.67), daytime somnolence (Hedges' g\u2009=\u20090.43), sleep disturbances (Hedges' g\u2009=\u20090.66), and poorer quality of life (Hedges' g\u2009=\u20091.23). Our analyses suggest that fatigue is a frequent, independent nonmotor symptom in PD appearing early and persisting throughout the disease course, and that establishing uniform diagnostic criteria for PD\u2010related fatigue is critical. In addition, several nonmotor symptoms appear to be associated with fatigue and negatively impact quality of life. Pharmacological and nonpharmacological interventions targeting fatigue and associated symptoms may improve quality of life in patients with PD. \u00a9 2018 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.27461","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T05:19:22Z","timestamp":1538111962000},"page":"1712-1723","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":264,"title":["Fatigue in Parkinson's disease: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"33","author":[{"given":"Mattia","family":"Siciliano","sequence":"first","affiliation":[{"name":"Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, MRI Research Center SUN\u2010FISM University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy"},{"name":"Department of Psychology University of Campania \u201cLuigi Vanvitelli\u201d  Caserta 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