Beyond tremor and rigidity: non-motor features of Parkinson's disease.
Parkinson's disease (PD) is the second most common neurodegenerative disease and primarily considered as a movement disorder defined by the presence of motor symptoms, such as bradykinesia, tremor and rigidity. However, it is nowadays widely accepted that PD is associated with a wide variety of non-motor features, which affect the vast majority of patients during the course of the disease and may even precede the onset of motor symptoms. The spectrum of these non-motor disturbances is very broad and comprises neuropsychiatric conditions, such as depression, dementia and hallucinations, as well as autonomic, sensory and sleep disorders. Physicians need to be aware of these non-motor features, since they have substantial impact on the health-related quality of life of PD patients, even ahead of motor symptoms. This article aims to provide an overview of frequently observed non-motor features in PD and discusses prospects and limitations of currently available options for symptomatic treatment of these disturbances.
Löhle
Matthias
M
Department of Neurology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany. matthias.loehle@neuro.med.tu-dresden.de
Storch
Alexander
A
Reichmann
Heinz
H
D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D003704:Dementia / Q000209:etiology / Q000503:physiopathology; D003866:Depressive Disorder / Q000209:etiology / Q000503:physiopathology; D006212:Hallucinations / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D009127:Muscle Rigidity / Q000150:complications; D019965:Neurocognitive Disorders / Q000209:etiology* / Q000503:physiopathology*; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D014202:Tremor / Q000150:complications
Mov Disord. 2005 Dec;20(12):1557-63
16078219
Mov Disord. 2005 Oct;20(10):1255-63
16041803
Physiol Behav. 1984 Mar;32(3):489-502
6463130
Neurology. 2003 May 13;60(9):1553-4
12743258
Neurourol Urodyn. 1995;14(2):131-9
7780440
J Neurol Neurosurg Psychiatry. 2004 May;75(5):689-95
15090561
Sleep Med. 2003 Jul;4(4):281-4
14592300
Arch Neurol. 2008 Sep;65(9):1191-4
18779422
Ann Neurol. 2002 Jun;51(6):722-9
12112078
Mov Disord. 2008 Jan 30;23(2):183-9; quiz 313
17987654
Mov Disord. 2007 Dec;22(16):2314-24
18098298
Sleep. 2004 Aug 1;27(5):967-72
15453556
J Clin Psychopharmacol. 1999 Oct;19(5):478-9
10505594
Mov Disord. 2006 Sep;21(9):1432-8
16773617
Neurology. 1992 Apr;42(4):726-32
1565224
J Neurol Neurosurg Psychiatry. 1997 Oct;63(4):434-40
9343119
Mov Disord. 2001 Nov;16(6):1176-7
11748757
Psychiatry Res. 1989 May;28(2):193-213
2748771
Br J Psychiatry. 1989 Sep;155:415-7
2638582
Neurology. 2003 Nov 11;61(9):1279-81
14610139
Mov Disord. 2005 Aug;20(8):958-63
15800937
Neurology. 2006 Apr 11;66(7):996-1002
16606910
Acta Psychiatr Scand. 1996 Dec;94(6):482-4
9021005
Mov Disord. 2006 May;21(5):704-7
16440332
Mov Disord. 2007 Dec;22(16):2306-13
17659637
Mov Disord. 2004 Sep;19(9):1043-9
15372593
J Neurol Neurosurg Psychiatry. 1998 Feb;64(2):178-83
9489527
N Engl J Med. 2004 Dec 9;351(24):2509-18
15590953
Neurology. 1996 Feb;46(2):388-93
8614500
J Clin Psychopharmacol. 2007 Feb;27(1):89-90
17224721
J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):629-35
12438461
Mov Disord. 2003 Jun;18(6):659-67
12784269
J Clin Psychiatry. 1995 Dec;56(12):556-9
8530331
Mov Disord. 2007 Jul 15;22(9):1239-44
17566120
N Engl J Med. 1999 Mar 11;340(10):757-63
10072410
J Neurol. 2008 Feb;255(2):255-64
18204803
Arch Neurol. 1999 May;56(5):595-601
10328255
Neurobiol Aging. 2003 Mar-Apr;24(2):197-211
12498954
Neurology. 1997 Oct;49(4):1168-70
9339713
Mov Disord. 2006 Aug;21(8):1119-22
16637039
Therapie. 2000 Sep-Oct;55(5):655-6
11201984
Clin Neuropharmacol. 2004 Jul-Aug;27(4):153-6
15319699
Clin Auton Res. 2005 Apr;15(2):76-82
15834763
Mov Disord. 2002 Nov;17(6):1221-6
12465060
Int J Geriatr Psychiatry. 1999 Oct;14(10):866-74
10521886
J Neurol. 2006 Feb;253(2):171-5
16096815
Mov Disord. 1998 Nov;13(6):895-9
9827612
Neurology. 2004 Jan 13;62(1):37-40
14718694
Mov Disord. 2002 Jan;17(1):60-7
11835440
JAMA. 2002 Jan 23-30;287(4):509-11
11798375
J Am Geriatr Soc. 2000 Aug;48(8):938-42
10968298
J Neurol Neurosurg Psychiatry. 2004 Dec;75(12):1749-52
15548497
Mov Disord. 1995 May;10(3):337-40
7651453
J Neurol Neurosurg Psychiatry. 2001 Jun;70(6):734-8
11385005
J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):343-8
15716523
Chem Senses. 1997 Feb;22(1):39-52
9056084
Mov Disord. 2006 Nov;21(11):1856-63
16941460
Mov Disord. 2003 Jun;18(6):685-8
12784273
J Clin Psychopharmacol. 2005 Dec;25(6):617-8
16282854
Cochrane Database Syst Rev. 2003;(3):CD003465
12917968
BMC Neurol. 2008 Jun 20;8:21
18570642
Neurology. 1995 Sep;45(9):1691-6
7675228
J Neurol. 2008 Mar;255(3):367-70
18343969
J Geriatr Psychiatry Neurol. 2005 Sep;18(3):149-54
16100104
Neurology. 1993 Sep;43(9):1690-2
8414013
Sleep. 2002 Dec;25(8):905-9
12489899
Neurology. 2007 Dec 4;69(23):2162-9
18056580
Neurology. 2000 Aug 22;55(4):539-44
10953188
Neurology. 2007 Jul 24;69(4 Suppl 1):S14-22
17646619
Neurology. 1988 Aug;38(8):1237-44
3399075
Mov Disord. 1999 Nov;14(6):922-7
10584665
Mov Disord. 2002 Sep;17(5):1031-5
12360554
Ann Pharmacother. 2007 Nov;41(11):1833-41
17925503
Parkinsonism Relat Disord. 2009 Aug;15(7):490-4
19138875
J Am Geriatr Soc. 2004 May;52(5):784-8
15086662
Neurology. 2000 Apr 25;54(8):1596-602
10762499
Clin Neurol Neurosurg. 2004 Mar;106(2):93-6
15003297
Rhinology. 1996 Dec;34(4):222-6
9050101
Mov Disord. 2007 Aug 15;22(11):1567-72
17534963
Neurology. 2002 Feb 12;58(3):465-8
11839852
Arch Neurol. 2003 Mar;60(3):387-92
12633150
Arch Neurol. 2004 Jan;61(1):97-102
14732626
J Neurol. 2008 Sep;255 Suppl 5:18-32
18787879
J Neurol. 2007 Sep;254(9):1227-32
17671806
J Urol. 1992 Nov;148(5):1549-57; discussion 1564
1279218
J Geriatr Psychiatry Neurol. 2007 Sep;20(3):161-5
17712099
Neurology. 2004 Apr 13;62(7):1224-6
15079034
Clin Neurol Neurosurg. 1988;90(2):151-4
3145164
Mov Disord. 2008 Dec 15;23(16):2267-302
18925578
Gen Hosp Psychiatry. 2007 Jan-Feb;29(1):72-4
17189751
Biol Psychiatry. 2002 Sep 1;52(5):438-45
12242060
Mov Disord. 2007 Oct 15;22(13):1901-11
17674410
Int Clin Psychopharmacol. 1999 Jan;14(1):33-6
10221640
Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837
17542011
J Neurol. 2005 Jul;252(7):753-64
15999234
Neurol Sci. 2002 Sep;23 Suppl 2:S89-90
12548358
J Neurol Sci. 1996 Oct;142(1-2):151-2
8902736
Pharmacopsychiatry. 2002 May;35(3):109-11
12107855
Mov Disord. 2004 Nov;19(11):1306-12
15390007
Sleep. 1991 Dec;14(6):540-5
1798888
J Neurol Neurosurg Psychiatry. 2002 Jun;72(6):708-12
12023410
Neurology. 2001 Mar 27;56(6):730-6
11274306
Neurology. 1998 Aug;51(2):526-9
9710029
J Neurol. 2008 Sep;255 Suppl 5:39-47
18787881
Ann Neurol. 2008 Feb;63(2):167-73
18067173
Neurology. 2007 Jul 24;69(4):333-41
17646625
J Neural Transm (Vienna). 2004 Oct;111(10-11):1447-53
15480845
Mov Disord. 2008 Apr 30;23(6):850-7
18311826
J Urol. 2000 Nov;164(5):1640-3
11025724
Clin Neuropharmacol. 2006 Nov-Dec;29(6):331-7
17095896
Sleep. 2003 Dec 15;26(8):1049-54
14746389
Acta Neuropathol. 1988;76(3):217-221
2850698
Mov Disord. 2003 Mar;18(3):287-93
12621632
Am J Geriatr Psychiatry. 2005 Oct;13(10):844-51
16223962
Parkinsonism Relat Disord. 2009 Jun;15(5):379-82
18977165
Neurology. 2009 Mar 10;72(10):886-92
19092112
Arch Neurol. 1995 Jul;52(7):695-701
7619026
Mov Disord. 2008 Jul 30;23(10):1361-9
18546344
Mov Disord. 2007 Feb 15;22(3):313-8
17034006
Mov Disord. 2003 Jun;18(6):668-72
12784270
J Neurol Neurosurg Psychiatry. 1960 Nov;23:283-90
13711997
Neurologist. 2007 Sep;13(5):294-301
17848868
Neurology. 1986 Aug;36(8):1130-3
3736883
Mov Disord. 2001 May;16(3):507-10
11391746
Mov Disord. 2003 Apr;18(4):414-8
12671948
J Neuropsychiatry Clin Neurosci. 2000 Summer;12(3):364-9
10956570
Lancet Neurol. 2005 Jul;4(7):423-31
15963445
Psychosomatics. 1998 Mar-Apr;39(2):177-8
9584547