Nonmotor symptoms in Parkinson's disease: classification and management

Abstract:

Despite the emphasis on the motor phenotype of Parkinson’s disease (PD), it has been increasingly recognized that PD patients experience several nonmotor symptoms (NMS), which have even greater significance when assessed by quality-of-life measures and institutionalization rates. The burden of NMS tends to increase with age and disease severity and, in the very advanced stage of disease, NMS such as urinary problems, drooling, somnolence, psychosis, and dementia dominate the clinical phenotype. Moreover, the dopaminergic treatment used for the motor symptoms of PD can arise or worsen a number of NMS, including orthostatic hypotension, nausea, sleep disturbances, hallucinations, or impulsive compulsive behaviors. Here we review the most common NMS of PD with a focus on their pharmacological management.

Keywords::

• disease management
• PD
• NMS

Author contribution

RE, GS, PB, and CV made substantial contributions to the conception and design, acquisition of data, and analysis and interpretation of data, drafted the article and revised it critically for intellectual content, and had final approval of the version to be published.

Disclosure

The authors report no conflicts of interest in this work.