As one of the most frequent symptoms, measurement of fatigue is an issue of interest in Parkinson’s disease (PD). The fatigue severity scale (FSS) is one of the recommended questionnaires for this purpose. The aim of our study was to evaluate psychometric properties of the Persian version of the FSS (FSS-Per) to assess fatigue in PD patients. Ninety nondemented idiopathic Parkinson’s disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. In addition to the disease severity scales, the FSS-Per was used for fatigue measurement. The internal consistency coefficient was larger than 0.8 for all of the items with a total Cronbach’s alpha of 0.96 (95% CI: 0.95–0.97). The FSS-Per score correlated with the UPDRS score ( , ) and the “Hoehn and Yahr” (HY) stage ( , ). The total score of the FSS-Per significantly discriminated IPD patients with more severe disability (HY stage > 2) versus those with less severe disease (HY stage ) (AUC = 0.81 (95% CI: 0.72–0.90)). The FSS-Per fulfilled a high internal consistency and construct validity to measure the severity of fatigue in Iranian IPD patients. These acceptable psychometric properties were reproducible in subgroups of IPD patients regarding different levels of education, disease severity, sex and age groups. 1. Introduction Fatigue is one of the most disabling nonmotor symptoms of Parkinson’s disease (PD) [1]. It has been defined as a feeling of abnormal and overwhelming tiredness and shortage of energy, which is distinct from normal tiredness both in quality and quantity [2]. Because of its multidimensionality and lack of a universal definition, there are a large number of questionnaires measuring different aspects of fatigue [3]. However, there is no single multidimensional questionnaire, validated in patients with PD [3]. Based on a review done by the International Movement Disorders Society (IMDS), only a few scales are recommended for measuring fatigue severity in PD, one of which is the fatigue severity scale (FSS) [4]. The FSS is a self-report, one-dimensional scale, which was primarily developed in 1989 for patients with multiple sclerosis [5]. This scale does not specifically measure cognitive fatigue [6] and contains nine brief items, each of which is graded from 1 (strong disagreement) to 7 (strong agreement) [5]. Although many studies have previously shown the clinimetric properties of the FSS in different chronic diseases [5, 7–11], there are few validation reports in PD. On the other hand, even though the FSS has been validated in different languages,
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