Nonmotor symptoms in Parkinson's disease: classification and management

Abstract

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 institutionaliza-tion 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.