Nonmotor Symptoms in Parkinson's Disease

The recognition and treatment of nonmotor symptoms are increasingly emphasized in the care of Parkinson's disease (PD) patients. This manuscript will review signs and symptoms localized, generally, to the cortex, basal ganglia, brainstem, spinal cord, and peripheral nervous system. Cortical manifestations include dementia, mild cognitive impairment, and psychosis. Apathy, restlessness (akathisia), and impulse control disorders will be linked as basal ganglia symptoms. Symptoms attributed to the brainstem comprise depression, anxiety, and sleep disorders. Peripheral nervous system disturbances may lead to orthostatic hypotension, constipation, pain, and sensory disturbances.