title: [Non-motor symptoms in Parkinson's disease: cognition and behavior].
abstract: Although the diagnosis of Parkinson disease is based on motor symptoms, it is now well known that non-motor symptoms are an integral part of this pathology, involving in fact multiple systems. These non-motor symptoms affect large population of patients and can appear sometimes before the motor disorders. The non-motor symptoms include mainly neuropsychological difficulties, neuropsychiatric symptoms, and autonomic disorders, but involve also pain and sleep disturbances for example. Depression may occur at any stage of the disease, and consists in major depressive disorder, minor depressive disorder, and dysthymia. During the course of the disease, 50% of patients experience anxiety. Apathy is present in up to 30-40% of patients, due to loss of motivation, appearing in emotional, intellectual and behavioral domains. Dopamine dysregulation syndrome and impulse control disorders are not rare, and in relation with dopaminergic therapies. Impulse control disorders include pathological gambling, hyper sexuality, compulsive shopping, and eating disorder. Visual hallucinations can occur in 30% of patients, mostly induced by dopaminergic therapies. Often, they have deeper impact on the quality of life than the motor symptoms themselves, which stay the focus of attention during consulting. Identifying those can help in providing better care with a positive impact on the quality of life of the patients.
authors.affiliation: Inserm CIC 9503, CRICM UMR S975, Département de neurologie, Groupe hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Bonnet
authors.forename: Virginie
authors.initials: V
authors.lastname: Czernecki
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D057565:Apathy / Q000502:physiology; D001921:Brain / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D003702:Delusions / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D004298:Dopamine / Q000502:physiology; D006212:Hallucinations / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology
chemical_list: D004298:Dopamine
keywords: anxiety; apathy; cognitive decline; depression; hallucinations; impulse control disorder; non-motor symptoms