Treatment of Nonmotor Symptoms Associated with Parkinson Disease

Neurol Clin. 2020 May;38(2):269-292. doi: 10.1016/j.ncl.2019.12.003. Epub 2020 Feb 12.

Abstract

Parkinson disease (PD) is well recognized by its motor features of bradykinesia, tremor, rigidity, and gait and balance difficulties. However, PD is also characterized by a myriad of nonmotor symptoms, which may occur even before motor symptoms, early in the course of disease, and throughout the advancing disease. These nonmotor symptoms span multiple different systems, invoke multiple different neurotransmitters, and require multiple strategies for treatment including pharmacologic and nonpharmacologic interventions and, often, multiple different disciplines. This article discusses symptoms, assessments, and therapeutics for the nonmotor symptoms of PD including those affecting mood, cognition, behavior, sleep, autonomic function, and sensory systems.

Keywords: Anxiety; Apathy; Autonomic symptoms; Cognition; Dementia; Depression; Psychosis; Sensory symptoms.

Publication types

  • Review

MeSH terms

  • Cognition Disorders / etiology
  • Cognition Disorders / therapy
  • Constipation / etiology
  • Constipation / therapy
  • Humans
  • Hypotension, Orthostatic / etiology
  • Hypotension, Orthostatic / therapy
  • Mental Disorders / etiology
  • Mental Disorders / therapy
  • Parkinson Disease / complications*
  • Parkinson Disease / therapy*
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / therapy
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / therapy