title: Non motor subtypes and Parkinson's disease.
abstract: Non motor symptoms (NMS) represent a significant burden in Parkinson's disease (PD) with numerous studies highlighting the importance of NMS both in "pre-motor" phase of PD as well as throughout the course of disease. In part this has led the international Parkinson and Movement Disorder Society (IPMDS) task force to attempt a re-definition of PD incorporating NMS and not base the diagnosis solely on motor symptoms. While motor subtypes within PD have been recognized and researched, recent clinical and neurobiological research suggests the existence of discrete non motor subtypes in PD, particularly in untreated (drug naïve) and early PD patients. Several independent observers have reported specific "clusters of NMS dominant PD" using a data driven approach in early and untreated PD patients while others have reported on the burden of NMS in untreated PD and specific NMS dominant phenotypes in untreated or treated PD using observational case series based data. In this review we report on specific NMS dominant phenotypes of PD as described in the literature using clinical observational studies and address pathophysiological concepts. A proposal for several NMS subtypes are reported combining clinical reports with, where possible, evidence base supporting probable biomarkers.
authors.affiliation: National Parkinson Foundation International Centre of Excellence, King's College London, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Sauerbier
authors.affiliation: Institute of Pharmaceutical Science, King's College London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Jenner
authors.affiliation: National Parkinson Foundation International Centre of Excellence, King's College London, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.
authors.forename: Antoniya
authors.initials: A
authors.lastname: Todorova
authors.affiliation: National Parkinson Foundation International Centre of Excellence, King's College London, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK. Electronic address: ray.chaudhuri@kcl.ac.uk.
authors.forename: K Ray
authors.initials: KR
authors.lastname: Chaudhuri
mesh_terms: D000818:Animals; D001933:Brain Stem / Q000473:pathology; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D019957:Motor Skills Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D009833:Olfactory Pathways / Q000473:pathology; D010300:Parkinson Disease / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D010641:Phenotype; D012893:Sleep Wake Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology
keywords: Non motor symptoms; Parkinson's disease; Subtyping