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Non-motor symptoms in advanced Parkinson’s disease 

Non-motor symptoms in advanced Parkinson’s disease
Non-motor symptoms in advanced Parkinson’s disease
Non-motor Symptoms of Parkinson's Disease (2 ed.)

Miguel Coelho

and Joaquim J. Ferreira


Parkinson’s disease (PD) is a progressive neurodegenerative disorder typically associated with neuronal loss of the dopaminergic neurons of the substantia nigra pars compacta, but the cholinergic, noradrenergic and serotonergic systems are also affected. Clinically, cardinal motor manifestations of PD are characterized by the slowly progressive onset of bradykinesia, rest tremor and rigidity. However, non-motor symptoms (NMS) of PD, such as dementia, depression, psychosis or dysautonomia, are now recognized as important features of the disease and a major source of disability, and they have been changing the way in which the progression of PD is conceived. Pathologically, most NMS seem to derive from cell loss outside the dopaminergic nigrostriatal system. There is an increase in the severity and extent of extra-nigral degeneration with advancing disease, as well as an accompanying increase in the frequency and severity of NMS.

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