Loading...
This article is a review of the evidence for involvement of nonmotor symptoms in the prodromal and manifesting stages of Parkinson disease (PD).
Pathological findings underlying nonmotor symptoms in PD are summarized first, followed by the clinical aspects of the autonomic symptoms (orthostatic hypotension, constipation, nausea, voiding problems, and hyperhidrosis) and sensory symptoms (hyposmia and pain). The authors place the timing of these symptoms within the framework of the staging of PD proposed by Braak. They conclude that both sets of complaints are frequent in PD and may be more disabling than the motor symptoms. They emphasize early identification of these nonmotor features, many of which are present in the prodromal phase.