Nonmotor symptoms as presenting complaints in Parkinson’s disease: a clinicopathological study

O'Sullivan, Sean S.; Williams, David R.; Gallagher, David A.; Massey, Luke A.; Silveira‐Moriyama, Laura; Lees, Andrew J.

doi:10.1002/mds.21813

Cited by 290Parkinson's Disease Mechanisms and TreatmentsDementia and Cognitive Impairment ResearchNeurological disorders and treatments

Nonmotor symptoms as presenting complaints in Parkinson’s disease: a clinicopathological study

O'Sullivan, Sean S., Williams, David R., Gallagher, David A., Massey, Luke A., Silveira‐Moriyama, Laura, Lees, Andrew J.·2008·Movement Disorders

DOI 10.1002/mds.21813

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Abstract

Nonmotor symptoms (NMS) are increasingly recognized as a significant cause of morbidity in later stages of Parkinson's disease (PD). Prodromal NMS are also a well recognized component of the clinical picture in some patients but the prevalence of NMS as presenting complaints, and their impact on clinical management, in pathologically-proven cases of PD is unknown. The presenting complaints of 433 cases of pathologically-proven PD archived at the Queen Square Brain Bank for Neurological Diseases were identified from the clinical case notes. 91/433 (21%) of patients with PD presented with NMS of which the most frequent were pain (15%), urinary dysfunction (3.9%), anxiety, or depression (2.5%). Presenting with NMS is associated with a delayed diagnosis of PD (Mann-Whitney U, P = 0.001). These patients were more likely to be misdiagnosed initially and were more likely to have been referred to orthopedic surgeons or rheumatologists than neurologists (nonmotor group 5.5% vs. motor group 44.2%, chi(2) P < 0.0001). NMS are commonly seen as presenting complaints in pathologically confirmed PD, and initial misdiagnosis may be associated with potentially inappropriate medical interventions. Presenting with NMS does not affect the motor response to medication, but is associated with shorter disease duration (chi(2) P = 0.016).

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Presentation with non-motor symptoms may delay the diagnosis of Parkinson's disease.
“presentation with non-motor symptoms may delay the diagnosis (O' Sullivan et al. 2008).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as O' Sullivan et al. 2008
Nonmotor symptoms, including chronic constipation and GI distress, precede motor symptoms in up to 80% of PD patients.
“Nonmotor symptoms, including chronic constipation and GI distress, precede motor symptoms in up to 80% of PD patients (O’Sullivan et al., 2008; Poirier et al., 2016; Unger et al., 2016).”
From Microbiome–microglia connections via the gut–brain axis (2019) · cites this paper as O’Sullivan et al., 2008

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Authors: O'Sullivan, S. S., Williams, D. R., Gallagher, D. A., Massey, L. A., Silveira‐Moriyama, L., & Lees, A. J.
Affiliations: UCL Queen Square Institute of Neurology (GB)
The Royal Free Hospital (GB)
ORCID: Williams, David R.
Gallagher, David A.
Silveira‐Moriyama, Laura
Lees, Andrew J.
Venue: Movement Disorders
Publisher: Wiley
Published: 2008-01
Volume: 23
Issue: 1
Pages: 101-106
ISSN: 0885-3185 (ISSN-L)
1531-8257
DOI: 10.1002/mds.21813
OpenAlex: W1980567992
Cited by: 290
References: 24
Citations by year: 2026: 8 · 2025: 8 · 2024: 14 · 2023: 14 · 2022: 8 · 2021: 22 · 2020: 21 · 2019: 12 · 2018: 15 · 2017: 18 · 2016: 17 · 2015: 12 · 2014: 17 · 2013: 27 · 2012: 27
FWCI: 8.06
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Movement Disorders (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: Parkinson's UK (G-0508)
Topics: Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Neurology › Neurological disorders and treatments
Keywords: Parkinson's disease, non-motor symptoms, presenting symptoms, prodromal symptoms, delayed diagnosis, misdiagnosis, pain, urinary dysfunction, anxiety, depression, disease duration
MeSH terms: Olfaction Disorders, Mental Disorders, Brain, Major Depressive Disorder, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Neurology, Orthopedics, Pain, Parkinson Disease, Referral and Consultation, Retrospective Studies, Rheumatology, Urinary Incontinence, Prevalence, Essential Tremor, Stroke

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Nonmotor symptoms as presenting complaints in Parkinson’s disease: a clinicopathological study

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