scholarly journals Unusual motor and non-motor symptoms and signs in the early stage of Parkinson’s disease

2016 ◽  
Vol 74 (10) ◽  
pp. 781-784 ◽  
Author(s):  
Hélio A. G. Teive ◽  
Délcio C. Bertucci Filho ◽  
Renato P. Munhoz

ABSTRACT Objective Patients with Parkinson’s disease (PD) may present with unusual motor and non-motor symptoms and signs in the early stage of the disease. Methods Cases were collected over a five-year period at two tertiary movement disorders clinics. All had a diagnosis of PD with unusual presentations defined retrospectively as the presence of complaints not objectively related to any of the classic cardinal signs of parkinsonism or the typical early non-motor features of PD. Results A total of 15 early PD patients fulfilled the proposed criteria, presenting with symptoms such as atypical tremors, shoulder pain, signs related to the rigid akinetic syndrome, as well as cases of asthenia, rhinorrhea, parosmia, dysgeusia, nocturnal sialorrhea, and color discrimination disorders. Conclusions Unusual motor and non-motor symptoms and signs in the early stage of PD can be difficult to interpret. Specialists should be aware of these conditions as clues to a potential diagnosis.

2021 ◽  
Vol 19 ◽  
Author(s):  
Yu Jin Jung ◽  
Han-Joon Kim ◽  
Sun Ha Paek ◽  
Beomseok Jeon

: Sleep-wake disturbances (SWD) are one of the most common non-motor symptoms in Parkinson's disease (PD) and can appear in the early stage even before the onset of motor symptoms. Deep brain stimulation (DBS) is an established treatment for the motor symptoms in patients with advanced PD. However, the effect of DBS on SWD and its specific mechanisms are not widely understood and remain controversial. In addition to the circuit-mediated direct effect, DBS may improve SWD by an indirect effect such as the resolution of nocturnal motor complications and a reduction of dopaminergic medication. Here, the authors review the recent literatures regarding the impact of DBS on SWD in patients with PD. Furthermore, the selection of the DBS targets and the specific effects of applying DBS to each target on SWD in PD are also discussed.


2020 ◽  
Vol 10 (23) ◽  
pp. 8732
Author(s):  
Seon Lee ◽  
Se-Hong Oh ◽  
Sun-Won Park ◽  
Chaewon Shin ◽  
Jeehun Kim ◽  
...  

The purpose of this study was to determine whether a support vector machine (SVM) model based on quantitative susceptibility mapping (QSM) can be used to differentiate iron accumulation in the deep grey matter of early Parkinson’s disease (PD) patients from healthy controls (HC) and Non-Motor Symptoms Scale (NMSS) scores in early PD patients. QSM values on magnetic resonance imaging (MRI) were obtained for 24 early PD patients and 27 age-matched HCs. The mean QSM values in deep grey matter areas were used to construct SVM and logistic regression (LR) models to differentiate between early PD patients and HCs. Additional SVM and LR models were constructed to differentiate between low and high NMSS scores groups. A paired t-test was used to assess the classification results. For the differentiation between early PD patients and HCs, SVM had an accuracy of 0.79 ± 0.07, and LR had an accuracy of 0.73 ± 0.03 (p = 0.027). SVM for NMSS classification had a fairly high accuracy of 0.79 ± 0.03, while LR had 0.76 ± 0.04. An SVM model based on QSM offers competitive accuracy for screening early PD patients and evaluates non-motor symptoms, which may offer clinicians the ability to assess the progression of motor symptoms in the patient population.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruwei Ou ◽  
Yanbing Hou ◽  
Qianqian Wei ◽  
Junyu Lin ◽  
Kuncheng Liu ◽  
...  

AbstractThe progression of global non-motor symptoms (NMS) in Chinese patients with Parkinson’s disease (PD) has not been explored. We aimed to examine the longitudinal evolution of overall NMS in a 3-year prospective Chinese cohort with early-stage PD. We included 224 patients with early PD who underwent annual evaluation of motor and non-motor symptoms. NMS was assessed using the non-motor symptoms scale (NMSS). We observed an increased number of NMS in the majority of the NMSS domains except mood/apathy and sexual dysfunctions. Significant deterioration was observed in the sleep/fatigue, perceptual problems/hallucinations, attention/memory, gastrointestinal, urinary, and miscellaneous domains during the follow-up (P < 0.05). Notably, the number and the score of sexual dysfunctions decreased with the progression of the disease. All NMSS domains showed a small effect size from baseline to 1-, 2-, and 3-year follow-ups (effect size < 0.5). The generalized estimating equations model indicated that the total number of NMS was significantly associated with age and the Unified Parkinson’s Disease Rating Scale (UPDRS) III score (P < 0.05). Multiple logistic regression indicated that a high number of NMS at baseline was associated with a 3-point, a 6-point, and a 9-point increase in the UPDRS III score from baseline to 1-year (odds ratio [OR] 1.074, P = 0.017), 2-year (OR 1.113, P = 0.001), and 3-year (OR 1.117, P < 0.001), respectively. Our study indicated that overall NMS evolution in early PD is mild and multidimensional; a high NMS burden in early PD predicts the faster motor progression of PD. Our study is helpful for understanding the longitudinal evolution of NMS in PD.


2021 ◽  
Vol 74 (5-6) ◽  
pp. 151-155
Author(s):  
Ferenc Nagy

Despite the continuous development of diagnosis and treatment of patients with Parkinson’s disease and the arrival of new therapeutic options in recent years the treatment and care of people with Parkinson’s disease especially in the advanced stage remains a major challenge for neurologists specialized in movement disorders. The treatment of Parkinson’s disease is adversely affected by several factors: the disease progresses relentlessly, the symptoms and rate of progression, other concomitant non-motor symptoms, and the appearance of complications caused by treatment show great heterogeneity. Based on all these factors it is difficult to develop and apply a uniform routine therapeutic guideline. This summary seeks to shed light on aspects of the treatment of Parkinson’s disease particularly in advanced-stage cases drawing on data from a professional college recommendation and the literature.


2021 ◽  
pp. 1-17
Author(s):  
Yu-Yan Tan ◽  
Peter Jenner ◽  
Sheng-Di Chen

Monoamine oxidase-B (MAO-B) inhibitors are commonly used for the symptomatic treatment of Parkinson’s disease (PD). MAO-B inhibitor monotherapy has been shown to be effective and safe for the treatment of early-stage PD, while MAO-B inhibitors as adjuvant drugs have been widely applied for the treatment of the advanced stages of the illness. MAO-B inhibitors can effectively improve patients’ motor and non-motor symptoms, reduce “OFF” time, and may potentially prevent/delay disease progression. In this review, we discuss the effects of MAO-B inhibitors on motor and non-motor symptoms in PD patients, their mechanism of action, and the future development of MAO-B inhibitor therapy.


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