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The role of continuous dopaminergic stimulation in the management of non-motor symptoms in Parkinson’s disease 

The role of continuous dopaminergic stimulation in the management of non-motor symptoms in Parkinson’s disease
Chapter:
The role of continuous dopaminergic stimulation in the management of non-motor symptoms in Parkinson’s disease
Source:
Non-motor Symptoms of Parkinson's Disease (2 ed.)
Author(s):

P. Reddy

, A. Antonini

, and P. Odin

DOI:
10.1093/med/9780199684243.003.0031

Non-motor symptoms (NMS) in PD have a significant impact on the quality of life of patients and yet they are under-recognized and under-treated. This is mainly due to poor awareness and an insufficient evidence base for treating the NMS. The motor features of PD largely arise from dopamine deficiency in the substantia nigra and related dysfunction in the striato-cortical loops. Other neurotransmitter systems are also involved in PD, with depletion of acetylcholine, norepinephrine, and serotonin levels. Current treatment has largely focused on replacing endogenous dopamine via the administration of levodopa or other dopaminergic drugs. Some, but not all, NMS in PD (sleep disorders, autonomic dysfunction and fatigue) have a dopaminergic basis. Treating NMS in PD remains a significant unmet challenge, but some, especially those associated with #amp;#x2018;off#amp;#x2019; periods, may be relieved using continuous dopaminergic stimulation.

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