Title:Advances in the Pharmacological and Non-pharmacological Management
of Non-motor Symptoms in Parkinson’s Disease: An Update Since 2017
Volume: 21
Issue: 8
Author(s): Daniel J. Van Wamelen*, Katarina Rukavina, Aleksandra M. Podlewska and K. Ray Chaudhuri
Affiliation:
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience,
King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s
College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Neurology, Radboud University
Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Centre of Expertise for Parkinson & Movement
Disorders, Nijmegen, The Netherlands
Keywords:
Parkinson's disease, non-motor symptoms, autonomic symptoms, neuropsychiatric symptoms, pain, treatment, nonpharmacological treatment.
Abstract:
Background: Non-motor symptoms (NMS) are an important and ubiquitous determinant
of quality of life in Parkinson’s disease (PD). However, robust evidence for their treatment is still a
major unmet need.
Objective: This study aimed to provide an updated review on advances in pharmacological, nonpharmacological,
and exercise-based interventions for NMS in PD, covering the period since the
publication of the MDS Task Force Recommendations.
Methods: We performed a literature search to identify pharmacological, non-pharmacological, and
exercise-based interventions for NMS in PD. As there are recent reviews on the subject, we have
only included studies from the 1st of January 2017 to the 1st of December 2021 and limited our
search to randomised and non-randomised (including open-label) clinical trials.
Results: We discuss new strategies to manage NMS based on data that have become available since
2017, for instance, on the treatment of orthostatic hypotension with droxidopa, several dopaminergic
treatment options for insomnia, and a range of non-pharmacological and exercise-based interventions
for cognitive and neuropsychiatric symptoms, pain, and insomnia and excessive sleepiness.
Conclusion: Recent evidence suggests that targeted non-pharmacological treatments, as well as
some other NMS management options, may have a significant beneficial effect on the quality of life
and need to be considered in the pathways of treatment of PD.
