The clinical symptoms of Parkinson's disease.

In the paper

“Depression and anxiety may also occur long before the diagnosis is made (Chen et al. 2013).”

What the sources say

• Supported

  The Introduction says that accumulating evidence suggests depression and anxiety may occur well before the motor dysfunction used to diagnose Parkinson’s disease. Its table also lists studies assessing both symptoms years before PD diagnosis. This supports the citing sentence’s qualified wording, “may.” (LLM, conf=0.94)

  cites Chen et al. 2013 source

In the paper

“These may start as early as 10 or more years before the diagnosis (Schrag et al. 2015)”

What the sources say

• Supported

  The Results (p. 5) report that constipation, a non-motor symptom, was more common in people later diagnosed with Parkinson’s disease at 10 years before diagnosis. The Discussion (p. 6) also reports an association between erectile dysfunction and a Parkinson’s diagnosis more than 10 years later, supporting the claim’s qualified wording. (LLM, conf=0.91)

  cites Schrag et al. 2015 source

In the paper

“Although obstructive sleep apnoea, where breathing stops intermittently during sleep, is well known in PD (Monderer and Thorpy 2008), not all studies have shown increased prevalence among patients (Zeng et al. 2013).”

What the sources say

• Supported

  The Discussion says many studies found similar rates of obstructive sleep apnea in Parkinson’s disease patients and controls. The Conclusion also reports that this meta-analysis found a lower risk in patients, supporting the narrower claim that not all studies found an increased prevalence. Page numbers were not provided in our copy. (LLM, conf=0.94)

  cites Zeng et al. 2013 source

In the paper

“Erectile dysfunction is common in males (Sakakibara et al. 2011).”

What the sources say

• Supported

  Section 4.3.1, “Male Sexual Symptoms,” reports that 79% of the men with Parkinson’s disease in a cited study had decreased erection, significantly more than healthy male controls. This supports the statement that erectile dysfunction is common in men with Parkinson’s disease. (LLM, conf=0.93)

  cites Sakakibara et al. 2011 source

In the paper

“One study showed that visual component was lacking in 10% of cases (Papapetropoulos and Heather Katzen 2008).”

What the sources say

• Partly supported

  The Discussion reports that seven of 70 Parkinson’s disease patients had hallucinations lacking a visual component, giving an overall prevalence of 10%. But the Results (Characteristics of hallucinators) state that those seven were 22.5% of the 31 patients who had hallucinations. Thus 10% applies to all patients studied, not to cases of hallucinations. (LLM, conf=0.92)

  cites Papapetropoulos and Heather Katzen 2008 sourceExperimental — accuracy not yet measured

In the paper

“Progression of the dementia shows a correlation with spread of the neuropathological changes to cortical brain structures (Irwin et al. 2012).”

What the sources say

• Partly supported

  The Introduction (page unavailable) describes a proposed spread of Lewy body and neurite pathology from the brainstem to the cerebral cortex. The Results and Discussion (pages unavailable) associate greater cortical pathology with dementia in Parkinson’s disease, but do not establish that progression of dementia itself correlates with the spread over time. (LLM, conf=0.83)

  cites Irwin et al. 2012 sourceExperimental — accuracy not yet measured

In the paper

“This may rarely be a prediagnostic symptom in PD (Tolosa and Compta 2006)”

What the sources say

• ?Not checked — no full text of the sourcecites Tolosa and Compta 2006 source

In the paper

“In young onset familial PD, dystonia typically involves the foot with cramp-like discomfort or inversion of the affected foot (Tolosa and Compta 2006).”

What the sources say

• ?Not checked — no full text of the sourcecites Tolosa and Compta 2006 source

In the paper

“In the majority of cases, the PD symptoms appear within 10 years from onset of the dystonia.”

What the sources say

• ?Not checked — no full text of the sourcecites Tolosa and Compta 2006 source

In the paper

“In PD, the blood pressure drop may last several minutes (Jost 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Jost 2003 source

In the paper

“The typical prediagnostic dystonias include unilateral equinovarus foot position, upper arm-forearm or forearmhand flexion, writer's cramp, oro-mandibular dystonia, torticollis or different combinations of these symptoms (Tolosa and Compta 2006).”

What the sources say

• ?Not checked — no full text of the sourcecites Tolosa and Compta 2006 source

In the paper

“In the end stage (stage 5-6), the process enters the neocortex with a wide variety of clinical manifestations (Braak et al. 2004).”

What the sources say

• ?Not checked — no full text of the sourcecites Braak et al. 2004 source

In the paper

“a quarter of the patients report dribbling of saliva (Kalf et al. 2012).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Kalf et al. 2012

In the paper

“Predictors of falls other than older age include duration of disease, dementia, symmetrical onset, postural and autonomic instability (Wood et al. 2002;Williams et al. 2006).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Wood et al. 2002
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Williams et al. 2006

In the paper

“Speech disturbances such as very quiet and hurried speech occur in more than half of the patients (Perez-Lloret et al. 2012)”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Perez-Lloret et al. 2012

In the paper

“With progression of the disease, substantia nigra and other nuclei of the midbrain and forebrain become affected (stages 3-4).”

What the sources say

• ?Not checked — no full text of the sourcecites Braak et al. 2004 source

In the paper

“but dystonic symptoms are mostly related to treatment, both medical and surgical (Jankovic and Tintner 2001).”

What the sources say

• ?Not checked — no full text of the sourcecites Jankovic and Tintner 2001 source

In the paper

“presentation with non-motor symptoms may delay the diagnosis (O' Sullivan et al. 2008).”

What the sources say

• ?Not checked — no full text of the sourcecites O' Sullivan et al. 2008 source

In the paper

“A quarter to 60% of patients experience freezing of movements usually after several years from onset (Virmani et al. 2015).”

What the sources say

• ?Not checked — no full text of the sourcecites Virmani et al. 2015 source

In the paper

“Another study reported falls in 62% of patients with PD (Stolze et al. 2004).”

What the sources say

• ?Not checked — no full text of the sourcecites Stolze et al. 2004 source

In the paper

“In elderly PD patients, this may mainly occur after food intake (Iodice et al. 2011).”

What the sources say

• ?Not checked — no full text of the sourcecites Iodice et al. 2011 source

In the paper

“Duration of PD may be unrelated to the occurrence of orthostatic hypotension (Jost and Augustis 2015).”

What the sources say

• ?Not checked — no full text of the sourcecites Jost and Augustis 2015 source

In the paper

“A study by Wood et al. (2002) showed that falls occurred in 68% of 109 patients with PD with a mean age of 75 years and mean disease duration of 3 years.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Wood et al. 2002

In the paper

“Early falls are atypical for those who are younger at onset but age is an independent risk factor for falls in PD (Williams et al. 2006)”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Williams et al. 2006

In the paper

“but glutamatergic, cholinergic, GABA-ergic, tryptaminergic, noradrenergic and adrenergic nerve cells may show similar damage in their cytoskeleton (Braak and Braak 2000).”

What the sources say

• ?Not checked — no full text of the sourcecites Braak and Braak 2000 source

In the paper

“It is estimated that up to 80% of dopaminergic cells in the nigro-striatal system are lost before the cardinal motor features of PD start to appear (Chung et al. 2001).”

What the sources say

• ?Not checked — no full text of the sourcecites Chung et al. 2001 source

In the paper

“There is formation of abnormal proteinaceous spherical bodies called Lewy bodies (Fig. 1), and a spindleor thread-like and, in part, branching Lewy neurites in the somata of the involved nerve cells, beginning at defined induction sites and advancing in a topographically predictable sequence within the nervous system (Braak et al. 2004).”

What the sources say

• ?Not checked — no full text of the sourcecites Braak et al. 2004 source

In the paper

“In the pre-symptomatic stages of the disease (stages 1-2), the inclusion bodies are confined to the medulla oblongata/pontine tegmentum and olfactory bulb/anterior olfactory nucleus.”

What the sources say

• ?Not checked — no full text of the sourcecites Braak et al. 2004 source

In the paper

“Constipation, dream-enacting behaviour (REM behaviour sleep disorder), frequent nightmares, daytime drowsiness and postprandial fullness were often reported to occur more than 10 years before onset of motor symptoms (Pont-Sunyer et al. 2015).”

What the sources say

• ?Not checked — no full text of the sourcecites Pont-Sunyer et al. 2015 source

In the paper

“Less commonly, the hallucinations are olfactory (McAuley and Gregory 2012), auditory (Inzelberg et al. 1998) and tactile (Fenelon et al. 2002).”

What the sources say

• ?Not checked — no full text of the sourcecites McAuley and Gregory 2012 source
• ?Not checked — no full text of the sourcecites Inzelberg et al. 1998 source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Fenelon et al. 2002

In the paper

“Dopamine dysregulation syndrome is most common in men with relatively young onset disease (Ceravolo et al. 2010).”

What the sources say

• ?Not checked — no full text of the sourcecites Ceravolo et al. 2010 source

In the paper

“Although virtually all anti-parkinsonian medications have been reported to induce hallucinations and psychosis, visual hallucinations have also been reported to occur prior to drug treatment (Pagonabarraga et al. 2016).”

What the sources say

• ?Not checked — no full text of the sourcecites Pagonabarraga et al. 2016 source

In the paper

“The syndrome of restless legs with or without periodic leg movements of sleep is more common among patients than controls (Monderer and Thorpy 2008).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Monderer and Thorpy 2008

In the paper

“It seems that nearly all available dopaminergic drugs may induce sleep attacks (Larsen and Tandberg 2001) and the dopaminergic treatment load may be implicated (Brodsky et al. 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Larsen and Tandberg 2001 source

In the paper

“With advancing disease patients may develop paranoid illusions often with persecutory ideas or suspicions towards the spouse (Williams-Gray et al. 2006).”

What the sources say

• ?Not checked — no full text of the sourcecites Williams-Gray et al. 2006 source

In the paper

“Other PD symptoms such as difficulties with turning around in bed, frequent nocturia, nocturnal tremor and depression may also lead to fractionated sleep (Lees et al. 1988).”

What the sources say

• ?Not checked — no full text of the sourcecites Lees et al. 1988 source

In the paper

“and the dopaminergic treatment load may be implicated (Brodsky et al. 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Brodsky et al. 2003 source

In the paper

“A variety of sleep disorders may appear with approximately two third of patients affected (Mehta et al. 2008).”

What the sources say

• ?Not checked — no full text of the sourcecites Mehta et al. 2008 source

In the paper

“These symptoms that together have been called dopamine dysregulation syndrome or impulse control disorders are increasingly recognized (Evans and Lees 2004).”

What the sources say

• ?Not checked — no full text of the sourcecites Evans and Lees 2004 source

In the paper

“Polysomnographic findings have shown changes in the architecture of sleep waves compared with healthy controls, but the medical treatment for different symptoms related to PD may also disrupt night-time sleep (Larsen and Tandberg 2001;Monderer and Thorpy 2009).”

What the sources say

• ?Not checked — no full text of the sourcecites Larsen and Tandberg 2001 source
• ?Not checked — no full text of the sourcecites Monderer and Thorpy 2009 source

In the paper

“Fractionated sleep is most common (Porter et al. 2008).”

What the sources say

• ?Not checked — no full text of the sourcecites Porter et al. 2008 source

In the paper

“The dopaminergic treatment may also induce behavioural abnormalities such as euphoria/hypomania, poor organisational skills, hypersexuality, abnormal hoarding or punting and risk taking behaviour (O'Sullivan et al. 2009).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites O'Sullivan et al. 2009

In the paper

“Urinary control disturbances include urinary frequency, urgency and incontinence (Jost 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Jost 2003 source

In the paper

“Patients may also experience difficulties in rectal evacuation because of rectal sphincter dysfunction (Mathers et al. 1989).”

What the sources say

• ?Not checked — no full text of the sourcecites Mathers et al. 1989 source

In the paper

“Age itself rather than age at onset of PD has been associated with incident dementia in PD (Aarsland et al. 2007)”

What the sources say

• ?Not checked — no full text of the sourcecites Aarsland et al. 2007 source

In the paper

“Depression and anxiety may relate to several factors, including advancing disease severity (Schrag et al. 2001).”

What the sources say

• ?Not checked — no full text of the sourcecites Schrag et al. 2001 source

In the paper

“A 6-year longitudinal study of 141 PD patient with average disease duration of 5 years and a mean age of 69 years showed a cumulative risk of dementia increasing from 8.5% at 1 year to nearly 50% by year 6 (Pigott et al. 2015).”

What the sources say

• ?Not checked — no full text of the sourcecites Pigott et al. 2015 source

In the paper

“and disease severity has been reported as the strongest predictor of dementia risk (Riedel et al. 2008).”

What the sources say

• ?Not checked — no full text of the sourcecites Riedel et al. 2008 source

In the paper

“Slowness of initiation of voluntary movements with progressive reduction in speed and amplitude of repetitive actions (bradykinesia) with one additional symptom, i.e., muscular rigidity, resting tremor or postural instability, are a prerequisite for the diagnosis (Hughes et al. 1992).”

What the sources say

• ?Not checked — no full text of the sourcecites Hughes et al. 1992 source

In the paper

“Braak et al. (2003) have mapped PD into six neuropathological disease stages.”

What the sources say

• ?Not checked — no full text of the sourcecites Braak et al. 2003 source

In the paper

“The diagnosis is based on defined criteria from the UK PD Brain bank (Table 1, Hughes et al. 1992).”

What the sources say

• ?Not checked — no full text of the sourcecites Hughes et al. 1992 source

In the paper

“The autonomic dysfunction is considered because of involvement of both the central and peripheral postganglionic autonomic nervous system (Jost 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Jost 2003 source

In the paper

“The degeneration of dopaminergic nigrostriatal neurons with Lewy bodies is regarded as the primary neuropathological correlate of motor impairment in Parkinson's disease, but glutamatergic, cholinergic, GABA-ergic, tryptaminergic, noradrenergic and adrenergic nerve cells may show similar damage in their cytoskeleton (Braak and Braak 2000).”

What the sources say

• ?Not checked — no full text of the sourcecites Braak and Braak 2000 source

In the paper

“Neuropathological changes in the amygdala and hippocampus caused by the disease process seem to be implicated in the aetiology (Williams-Gray et al. 2006).”

What the sources say

• ?Not checked — no full text of the sourcecites Williams-Gray et al. 2006 source

In the paper

“Different studies show that the mean duration until death ranges from 6.9 to 14.3 years with increased age and the presence of dementia as the highest predictors of increased mortality (Macleod et al. 2014).”

What the sources say

• ?Not checked — no full text of the sourcecites Macleod et al. 2014 source

In the paper

“Limb pain is most common, but oral, thoracal, abdominal and genital pain may also occur (Waseem and Gwinn-Hardy 2001).”

What the sources say

• ?Not checked — no full text of the sourcecites Waseem and Gwinn-Hardy 2001 source

In the paper

“Patients with PD have greater and earlier need for nursing home placements (Parashos et al. 2002), higher rates of emergency hospital admissions, longer admissions and higher in-hospital mortality than comparable general population (Low et al. 2015).”

What the sources say

• ?Not checked — no full text of the sourcecites Parashos et al. 2002 source

In the paper

“Musculoskeletal pain is reported by almost half of the patients, but such pain is common in this age group and may not always be related to the PD.”

What the sources say

• ?Not checked — no full text of the sourcecites Broen et al. 2012 source

In the paper

“Pain is reported by 40-85% of patients (Broen et al. 2012).”

What the sources say

• ?Not checked — no full text of the sourcecites Broen et al. 2012 source

In the paper

“Sensory symptoms are common in PD.”

In the paper

“With progression of the disease, treatment becomes heavier and drug response less reliable and the anti-parkinsonian drugs induce potentially disabling dyskinesias.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Poewe 2006

In the paper

“After prolonged disease duration of 10 or more years, a majority of patients will also have developed some non-motor symptoms for which there are currently limited available treatments.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Poewe 2006

In the paper

“Dystonic, radicular and central neuropathic pain are less common (Broen et al. 2012).”

What the sources say

• ?Not checked — no full text of the sourcecites Broen et al. 2012 source

In the paper

“Vague abnormal sensations in body parts may be perceived and these sensations may fluctuate in relation to treatment (Bayulkemand and Lopez 2011).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Bayulkemand and Lopez 2011

In the paper

“Limb pain may be the presenting symptom and misdiagnosed as a frozen shoulder or degenerative spine disease (Williams and Lees 2009).”

What the sources say

• ?Not checked — no full text of the sourcecites Williams and Lees 2009 source

In the paper

“Limb pain may be the presenting symptom and misdiagnosed as a frozen shoulder or degenerative spine disease (Williams and Lees 2009).”

What the sources say

• ?Not checked — no full text of the sourcecites Williams and Lees 2009 source

In the paper

“There is a great variability between patients in progression of symptoms (Poewe 2006).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Poewe 2006

In the paper

“Limb pain is most common, but oral, thoracal, abdominal and genital pain may also occur (Waseem and Gwinn-Hardy 2001).”

What the sources say

• ?Not checked — no full text of the sourcecites Waseem and Gwinn-Hardy 2001 source

In the paper

“Vague abnormal sensations in body parts may be perceived and these sensations may fluctuate in relation to treatment (Bayulkemand and Lopez 2011).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Bayulkemand and Lopez 2011

In the paper

“Reduced or lost sense of smell is found in at least 80% of patients and this often appears long before the motor symptoms (Doty et al. 1988).”

What the sources say

• ?Not checked — no full text of the sourcecites Doty et al. 1988 source

In the paper

“Reduced or lost sense of smell is found in at least 80% of patients and this often appears long before the motor symptoms (Doty et al. 1988).”

What the sources say

• ?Not checked — no full text of the sourcecites Doty et al. 1988 source

In the paper

“Different studies show that the mean duration until death ranges from 6.9 to 14.3 years with increased age and the presence of dementia as the highest predictors of increased mortality (Macleod et al. 2014).”

What the sources say

• ?Not checked — no full text of the sourcecites Macleod et al. 2014 source