Neurological update: non-motor symptoms in atypical parkinsonian syndromes

Abstract

Among people with Parkinson’s disease (PD), non-motor symptoms (NMS) are a well-recognised cause of significant morbidity and poor quality of life. Yet, it is only more recently that NMS have been recognised to affect the lives of patients with atypical parkinsonian syndromes in a similar fashion. The aim of this article is to highlight and compare the relative prevalence of NMS among patients with atypical parkinsonian syndromes in the published literature, which largely remain underreported and unaddressed in routine clinical practice. All NMS that are recognised to occur in PD are also found to commonly occur in atypical parkinsonian syndromes. In particular, excessive daytime sleepiness is more prevalent among atypical parkinsonian syndromes (94.3%) compared to PD (33.9%) or normal controls (10.5%) (p < 0.001). Urinary dysfunction (not limited to urinary incontinence) is not only found to occur in MSA (79.7%) and PD (79.9%), but has also been reported in nearly half of the patients with PSP (49.3%), DLB (42%) and CBD (53.8%) (p < 0.001). Apathy is significantly more common among the atypical parkinsonian syndromes [PSP (56%), MSA (48%), DLB (44%), CBD (43%)] compared to PD (35%) (p = 0.029). Early recognition and addressing of NMS among atypical parkinsonian syndromes may help improve the holistic patient care provided and may encompass a range of conservative and pharmacotherapeutic treatments to address these symptoms.

The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis

“…Actually, most patients presented with either MSA-P or MSA-C, but signs of autonomic failure are always present [ 3 , 16 ]. It showed that urinary tract symptoms were present in 79.7% of the MSA patients [ 17 ]. Nonetheless, our findings indicate an elevated susceptibility to urinary system disorders, such as urinary tract infections, among patients with MSA-P rather than in patients with MSA-C.…”

“…Consequently, these patients may be promptly referred to a urologist even for subtle urological disorders. On the other side, urological symptoms associated with MSA were frequently mistaken for benign prostatic hyperplasia symptoms, resulting in unnecessary urological surgery [ 17 ]. It is not clear whether this factor contributes to the elevated incidence of prostatic hyperplasia as well.…”

Parkinson's disease and Parkinsonism syndromes: Evaluating iron deposition in the putamen using magnetic susceptibility MRI techniques - A systematic review and literature analysis

“…Idiopathic PD (iPD) is a typical progressive neurodegenerative condition that affects approximately 1% of adults over the age of 65 [ 27 ]. The following conditions can mimic iPD called atypical Parkinsonism: multiple system atrophy (MSA), corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB) [ 29 , [35] , [36] , [37] ]. Other causes of Parkinsonism include secondary causes, such as vascular Parkinsonism (VaP) and drug-induced Parkinsonism, genetic causes, tremor disorders, and non-neurological differentials of PD [ 29 , 38 ].…”

Deep Learning-Based Method for Detecting Parkinson using 1D Convolutional Neural Networks and Improved Jellyfish Algorithms

“…The motor symptoms involve trembling and a lack of energy in the hands and legs, constipation, difficulty doing daily tasks, and a shuffled gait when walking [2]. Parkinson's disease non-motor symptoms include a variety of problems, including weariness, constipation, difficulty speaking, memory loss, and exhaustion [3]. Studies suggest that voice problems arise in about 90 percent of PD cases [4].…”