35. Overview of the Medical Treatment of the Non-Motor and Non-Dopaminergic Features of Parkinson's Disease

  1. C. Warren Olanow MD, FRCPC3,4,5,
  2. Fabrizio Stocchi MD, PhD6 and
  3. Anthony E. Lang MD, FRCPC7,8,9
  1. Mark Stacy MD1 and
  2. Joseph Jankovic MD2

Published Online: 27 JUN 2011

DOI: 10.1002/9781444397970.ch35

Parkinson's Disease: Non-Motor and Non-Dopaminergic Features

Parkinson's Disease: Non-Motor and Non-Dopaminergic Features

How to Cite

Stacy, M. and Jankovic, J. (2011) Overview of the Medical Treatment of the Non-Motor and Non-Dopaminergic Features of Parkinson's Disease, in Parkinson's Disease: Non-Motor and Non-Dopaminergic Features (eds C. W. Olanow, F. Stocchi and A. E. Lang), Blackwell Publishing Ltd., Oxford, UK. doi: 10.1002/9781444397970.ch35

Editor Information

  1. 3

    Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA

  2. 4

    Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA

  3. 5

    Robert and John M. Bendheim Parkinson's Disease Center, Mount Sinai School of Medicine, New York, NY, USA

  4. 6

    Parkinson's Disease and Movement Disorders Research Centre, Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy

  5. 7

    Division of Neurology, University of Toronto, Toronto, ON, Canada

  6. 8

    Parkinson's Disease Research, University of Toronto, Toronto, ON, Canada

  7. 9

    Movement Disorder Centre, Toronto Western Hospital, Toronto, ON, Canada

Author Information

  1. 1

    Division of Neurology, Duke University Medical School, Durham, NC, USA

  2. 2

    Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA

Publication History

  1. Published Online: 27 JUN 2011
  2. Published Print: 29 JUL 2011

ISBN Information

Print ISBN: 9781405191852

Online ISBN: 9781444397970

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Keywords:

  • dementia;
  • hallucinations;
  • psychosis;
  • depression;
  • impulse control disorders;
  • rapid eye movement behavior disorder;
  • orthostatic hypotension;
  • pain;
  • salivary disturbances;
  • pulmonary disturbances;
  • Parkinson's disease

Summary

The non-motor and non-dopaminergic features of Parkinson's disease (PD) are increasingly being recognized as important sources of disability. Research is now being directed at understanding better the pathophysiologic basis of these problems and developing clinical interventions that might benefit them. Cognitive and behavioral changes, including dementia, psychosis, depression, apathy, anxiety, restlessness, impulse control disorders, and compulsive disorders, are among the most devastating. Other important non-motor and non-dopaminergic symptoms probably related to involvement of the caudal brainstem and autonomic nervous system include sleep disorders, dysphagia, dysarthria, sialorrhea, orthostatic hypotension, constipation, breathing disturbances, pain, and sensory problems. In addition, there are a variety of non-neurologic conditions associated with PD, such as postural and joint deformities and dermatitis, that can be problematic for patients. This chapter describes the clinical characteristics and possible pathogenic mechanisms of these and other non-motor symptoms and focuses on possible therapeutic strategies. Some of these areas are reviewed in detail in other chapters. We do not consider gait and postural disturbances, which are extensively covered elsewhere in this volume.