Cited by 2,807Parkinson's Disease Mechanisms and TreatmentsDeep Brain Stimulation and Movement DisordersDementia and Cognitive Impairment Research

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Non-motor symptoms of Parkinson's disease: diagnosis and management

Chaudhuri, K Ray, Healy, Daniel G, Schapira, Anthony HV·2006·The Lancet Neurology

DOI 10.1016/s1474-4422(06)70373-8

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Abstract

The clinical diagnosis of Parkinson's disease rests on the identification of the characteristics related to dopamine deficiency that are a consequence of degeneration of the substantia nigra pars compacta. However, non-dopaminergic and non-motor symptoms are sometimes present before diagnosis and almost inevitably emerge with disease progression. Indeed, non-motor symptoms dominate the clinical picture of advanced Parkinson's disease and contribute to severe disability, impaired quality of life, and shortened life expectancy. By contrast with the dopaminergic symptoms of the disease, for which treatment is available, non-motor symptoms are often poorly recognised and inadequately treated. However, attention is now being focused on the recognition and quantitation of non-motor symptoms, which will form the basis of improved treatments. Some non-motor symptoms, including depression, constipation, pain, genitourinary problems, and sleep disorders, can be improved with available treatments. Other non-motor symptoms can be more refractory and need the introduction of novel non-dopaminergic drugs. Inevitably, the development of treatments that can slow or prevent the progression of Parkinson's disease and its multicentric neurodegeneration provides the best hope of curing non-motor symptoms.

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Biopsable Neural Tissues: Toward New Biomarkers for Parkinson's Disease?
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“symptoms, especially dementia, are known to occur lately in the evolution of the disease and to reflect disease progression and severity (Chaudhuri et al., 2006).”
Background
PET Imaging of Mitochondrial Complex I with 18F-BCPP-EF in the Brains of MPTP-Treated Monkeys
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“contrast, several recent studies suggested that other monoaminergic neurons, such as serotonin and noradrenalin, may be affected in nondopaminergic brain regions of PD patients (22,23), indicating that multiparametric PET imaging with PET probes for other kinds of monoamines or with PET probes for a more general neuro…”
Result
Apomorphine pump in advanced Parkinson's disease: Effects on motor and nonmotor symptoms with brain metabolism correlations
Auffret, M., Jeune, F. L., Maurus, A., Drapier, S., Houvenaghel, J., Robert, G. H., Sauleau, P., & Vérin, M. (2016) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2016.11.080 · Cited by 42
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Early fine motor impairment and behavioral dysfunction in (Thy‐1)‐h[A30P] alpha‐synuclein mice
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Environmental Enrichment Prevents Transcriptional Disturbances Induced by Alpha-Synuclein Overexpression
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“, depression and anxiety) (Chaudhuri et al., 2006), and (ii) a central brain hub for integrating sensory information from external stimuli (Kempermann et al.”
Background
Sensor Array for Detection of Early Stage Parkinson’s Disease before Medication
Finberg, J. P. M., Schwartz, M., Jeries, R., Badarny, S., Nakhleh, M. K., Daoud, E. A., Ayubkhanov, Y., Abud-Hawa, M., Broza, Y. Y., & Haick, H. (2018) · ACS Chemical Neuroscience · doi:10.1021/acschemneuro.8b00245 · Cited by 42
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“24 Autonomic dysfunction is prevalent among PwP, and orthostatic hypotension (OH) is one of the phenomena of autonomic dysfunction in PD, which presents both before and after the onset of motor symptoms.”
Genetically engineered animal models of Parkinson's disease: From worm to rodent
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Proteomics in Human Parkinson’s Disease: Present Scenario and Future Directions
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Autonomic failure in Parkinson’s disease is associated with striatal dopamine deficiencies
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Beneficial effect of transcranial magnetic stimulation on sleep in Parkinson's disease
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“A primary factor is degeneration of central sleep regulation centres in the brainstem.(5) Sleep disorders in PD may also be secondary to dopaminergic medication, nocturnal akinesia and nonmotor symptoms such as depression and restless legs syndrome.”
Background
The impact of comorbidity and other clinical and sociodemographic factors on health-related quality of life in Greek patients with Parkinson's disease
Andreadou, E., Anagnostouli, M. C., Vasdekis, V., Kararizou, E. G., Rentzos, M., Kontaxis, T., & Evdokimidis, I. (2011) · Aging & Mental Health · doi:10.1080/13607863.2011.569477 · Cited by 45
“Since there is no known neuroprotective or regenerative treatment, current management focuses on the improvement of both motor and non-motor symptoms that deteriorate health-related quality of life (HRQoL) of affected patients (Chaudhuri, Healy, & Schapira, 2006 ; Welsh, 2004 ).”
Background
6-Hydroxydopamine impairs mitochondrial function in the rat model of Parkinson’s disease: respirometric, histological, and behavioral analyses
Kupsch, A. R., Schmidt, W., Gizatullina, Z. Z., Dębska–Vielhaber, G., Voges, J., Striggow, F., Panther, P., Schwegler, H., Heinze, H., Vielhaber, S., et al. (2014) · Journal of Neural Transmission · doi:10.1007/s00702-014-1185-3 · Cited by 42
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Background
Prodromal Markers in Parkinson’s Disease: Limitations in Longitudinal Studies and Lessons Learned
Heinzel, S., Röeben, B., Ben‐Shlomo, Y., Lerche, S., Alves, G. W., Barone, P., Behnke, S., Berendse, H. W., Bloem, B. R., Burn, D. J., et al. (2016) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2016.00147 · Cited by 42
“, hyposmia, depression, autonomic dysfunction) are common in PD patients (Chaudhuri et al., 2006; Jankovic, 2008).”
Background
Pros and Cons of Medical Cannabis use by People with Chronic Brain Disorders
Suryadevara, U., Bruijnzeel, D. M., Nuthi, M., Jagnarine, D. A., Tandon, R., & Bruijnzeel, A. W. (2017) · Current Neuropharmacology · doi:10.2174/1570159x14666161101095325 · Cited by 43
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Background
Dopaminergic Lesion in the Olfactory Bulb Restores Olfaction and Induces Depressive-Like Behaviors in a 6-OHDA Model of Parkinson’s Disease
Ilkiw, J. L., Kmita, L. C., Targa, A., Noseda, A. C. D., Rodrigues, L. S., Dorieux, F. W. C., Fagotti, J., Santos, P. C. D., & Lima, M. M. S. (2018) · Molecular Neurobiology · doi:10.1007/s12035-018-1134-5 · Cited by 42
LRRK 2 gene mutations in the pathophysiology of the ROCO domain and therapeutic targets for Parkinson’s disease: a review
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Modeling Parkinson’s Disease Using Patient-specific Induced Pluripotent Stem Cells
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Daytime sleepiness may be an independent symptom unrelated to sleep quality in Parkinson’s disease
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Care Burden and Mental Ill Health in Spouses of People With Parkinson Disease Dementia and Lewy Body Dementia
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Neurogenic Erectile Dysfunction. Where Do We Stand?
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Authors: Chaudhuri, K. R., Healy, D. G., & Schapira, A. H.
Affiliations: Guy's and St Thomas' NHS Foundation Trust (GB)
The Royal Free Hospital (GB)
ORCID: Schapira, Anthony HV
Venue: The Lancet Neurology
Publisher: Elsevier BV
Published: 2006-03
Volume: 5
Issue: 3
Pages: 235-245
ISSN: 1474-4422 (ISSN-L)
DOI: 10.1016/s1474-4422(06)70373-8
OpenAlex: W1982535961
Cited by: 2,807
References: 140
Citations by year: 2026: 184 · 2025: 170 · 2024: 143 · 2023: 159 · 2022: 168 · 2021: 165 · 2020: 197 · 2019: 168 · 2018: 161 · 2017: 174 · 2016: 152 · 2015: 156 · 2014: 130 · 2013: 130 · 2012: 129
FWCI: 9.23
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Neurology (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords: Parkinson's disease, non-motor symptoms, depression, constipation, pain, genitourinary dysfunction, sleep disorders, substantia nigra pars compacta, neurodegeneration, quality of life, disability
MeSH terms: Autonomic Nervous System Diseases, Humans, Pain, Parkinson Disease, Psychotic Disorders, Sleep Wake Disorders, Disease Progression, Pain Management

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Non-motor symptoms of Parkinson's disease: diagnosis and management

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