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Non-motor symptoms in the early motor stages of Parkinson’s disease 

Non-motor symptoms in the early motor stages of Parkinson’s disease
Chapter:
Non-motor symptoms in the early motor stages of Parkinson’s disease
Source:
Non-motor Symptoms of Parkinson's Disease (2 ed.)
Author(s):

Eduardo Tolosa

, Carles Gaig

, Joan Santamaria

, and Yaroslau Compta

DOI:
10.1093/med/9780199684243.003.0003

Dysautonomia, sleep, neuropsychiatric and cognitive disturbances are non-motor symptoms (NMS) frequently prominent in mid- and late-stage Parkinson’s disease (PD). However, NMS can also occur in the early stages at the time of diagnosis, and some even precede the onset of the classical motor signs. It is indeed not uncommon that when initially presenting to the doctor patients describe symptoms which are seemingly unrelated to the motor system and may have been present for some time. Symptoms occurring in the early and prodromal phases include depression, nightmares, fatigue, pain, difficulties with concentration or prominent constipation. Most NMS that occur in early PD are currently thought to reflect the early involvement of PD-related lesions of nervous system structures other than the dopaminergic nigrostriatal pathway. These structures include the lower brainstem, olfactory and limbic structures and the peripheral autonomic nervous system.

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