title: Treatment of the motor and non-motor symptoms in Parkinson's disease according to cluster symptoms presentation.
abstract: The term Parkinson's disease has been changed in 'Parkinson's diseases' to describe different clinical entities observed in several studies investigating the existence of PD subtypes. PD patients could be grouped based on clinical features. By considering only motor symptoms, we can classically distinguish two groups: " the tremorigen-form" and "akinetic- rigidity-form" where resting tremor and akinesia/bradikynesia and rigidity are the most motor predominant symptoms, respectively. Non-motor symptoms (NMSs) are practically always present during the course of the disease and some of them (constipation, depressive status, hyposmia and anxiety) could even exist before the onset of classical motor symptoms. Many other NMSs and in particular hallucinations, cognitive impairment, sleep disorders and difficulty in swallowing strongly affect the advanced stage of disease, and represent a real therapeutic challenge when these symptoms are simultaneously present with different severity. If not adequately treated, they can increase the risk of hospitalization and admissions in nursing home, and profoundly and negatively influence the quality of life and participation in social activity of these patients. PD subtypes according to the combination of motor and non-motor symptoms have been recently proposed. This classification derives from cluster analysis which permits to identify statistically distinct subtypes of Parkinsonian patients according to the relevance of both motor and non-motor symptoms. In this point of view, we propose a schematic therapeutic approach of motor and non-motor symptoms in Parkinson's disease according to cluster symptoms presentation (motor and non-motor symptoms) and using medications that act on multiple domains of PD symptoms.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.forename: Antonio
authors.initials: A
authors.lastname: Saginario
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ceda
authors.forename: Laura
authors.initials: L
authors.lastname: Galuppo
authors.forename: Livia
authors.initials: L
authors.lastname: Ruffini
authors.forename: Anna
authors.initials: A
authors.lastname: Nardelli
authors.affiliation: Geriatric Unit, Laboratory of Disability Prevention, Geriatric and Rehabilitation Department, University Hospital of Parma, Parma, Via Gramsci 14, 43100, Italy. flauretani@ao.pr.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maggio
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006212:Hallucinations / Q000188:drug therapy; D006801:Humans; D009069:Movement Disorders / Q000188:drug therapy; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology*; D057285:Precision Medicine; D011788:Quality of Life; D014202:Tremor / Q000188:drug therapy
chemical_list: D000978:Antiparkinson Agents