Various Non-Motor Symptoms of Parkinson's Disease
Parkinson’s disease (PD) is often linked with motor symptoms such as tremors, stiffness, bradykinesia (slow movement), and postural instability. Non-motor symptoms (NMS) are also common, if not more so, and can have a substantial influence on the quality of life for people suffering from the disease. These non-motor symptoms may occur years before the motor symptoms do and can increase as the disease advances.
Understanding the non-motor elements of Parkinson’s disease is critical for its overall management and care. These symptoms can influence numerous systems in the body, including sleep disruptions, cognitive impairment, emotional disorders, autonomic dysfunction, and sensory abnormalities. The following is a detailed examination by Jaslok Hospital of the many non-motor symptoms of Parkinson’s disease.
1. Cognitive Dysfunction and Dementia
Cognitive impairment is among the most common non-motor signs of Parkinson’s disease. It might vary from moderate cognitive impairment to full-blown dementia. While not all Parkinson’s patients get dementia, their risk is much higher than in the general population.
Symptoms of Cognitive Dysfunction and Dementia:
- Planning and arranging tasks is difficult (executive dysfunction).
- Impaired memory, particularly when recalling new information.
- Trouble concentrating or paying attention.
- Slower thinking (bradyphrenia).
Cognitive Dysfunction and Dementia Management:
- Cognitive training and brain exercises may aid in maintaining mental agility.
- Cholinesterase inhibitors, which are routinely used in Alzheimer’s disease, are sometimes given as the treatments to treat cognitive problems in Parkinson’s.
2. Mood Disorders (Depression, Anxiety, Apathy)
Mood disorders, notably depression and anxiety, are common among Parkinson’s patients, accounting for about half of all cases. These mental abnormalities frequently occur early in the illness progression, sometimes before motor symptoms become apparent.
Depression:
- Feelings of sadness, hopelessness, or a lack of interest in life.
- Fatigue and lack energy.
- Sleep patterns change (insomnia or excessive sleep).
Anxiety:
- Persistent worry or fear, which can be generalized or related to specific situations like social interactions.
- Panic attacks occur in severe circumstances.
- Physical symptoms include a rapid heartbeat and shortness of breath.
Apathy:
- Lack of motivation or interest in previously enjoyed activities.
- Emotional flatness and trouble starting tasks.
Mood Disorders Management:
- Antidepressants or anti-anxiety medications may be prescribed.
- Cognitive-behavioral therapy (CBT) is beneficial for treating both depression and anxiety.
- Encouraging physical exercise and social engagement may reduce some of the symptoms.
3. Sleep Disturbances
Sleep issues are another prevalent non-motor symptom of Parkinson’s disease that can significantly impair everyday functioning. Sleep problems might include trouble falling asleep, staying asleep, and getting restorative sleep.
Types of Sleep Disorders:
- Insomnia: Difficulty falling or staying asleep.
- REM Sleep Behavior Disorder (RBD): Acting out dreams, which can sometimes cause damage.
- Restless Legs Syndrome (RLS): A strong desire to move the legs, typically accompanied by unpleasant sensations.
- Excessive Daytime Sleepiness (EDS): refers to feeling unusually fatigued throughout the day despite obtaining enough sleep at night.
Sleep Disorder Management:
- Medications like melatonin or clonazepam can help control REM sleep behavior disorder.
- Adjusting dopamine drugs can aid with sleep quality in some circumstances.
- Good sleep hygiene practices, such as a consistent sleep schedule and a soothing bedtime routine, can help you sleep better.
4. Autonomic Dysfunction
Parkinson’s disease can damage the autonomic nerve system, which regulates involuntary body activities like blood pressure, digestion, and temperature.
Common Autonomic Dysfunction Symptoms:
- Orthostatic Hypotension: It is a quick drop in blood pressure when standing up, resulting in dizziness or fainting.
- Constipation: It is the slow movement of the digestive tract, which is commonly caused by low dopamine levels that influence gut motility.
- Bladder dysfunction: It is defined as urinary urgency, frequency, or incontinence.
- Sexual dysfunction: It includes erectile dysfunction in men and diminished sexual drive in both sexes.
Autonomic Dysfunction Management:
- For orthostatic hypotension, increasing fluid and salt intake or using medications like fludrocortisone can help.
- Constipation can be relieved with dietary changes, fiber supplements, and drugs such as laxatives.
- Anticholinergic drugs, as well as pelvic floor exercises, may be used to treat bladder dysfunction.
5. Sensory Symptoms
Parkinson’s disease can also influence sensory perception, resulting in a variety of odd experiences or abnormalities in sensory function.
Common Sensory Symptoms:
- Olfactory Dysfunction: Anosmia, or loss of smell, is a common early indicator of Parkinson’s disease and can develop years before motor symptoms appear.
- Pain: Parkinson’s patients may have a variety of pains, including musculoskeletal pain, neuropathic pain, or overall discomfort that is unrelated to movement.
- Vision Problems: Some persons with Parkinson’s disease may experience visual problems such as trouble focusing, double vision, or blurred vision.
Sensory Symptoms Management:
- Olfactory dysfunction typically does not have a treatment, but it can help with early diagnosis of the disease.
- Physical therapy, medicines, and alternative therapies such as acupuncture are options for pain management.
6. Gastrointestinal Issues
In addition to constipation, Parkinson’s patients may experience gastroparesis (slow stomach emptying), which can cause nausea, vomiting, and bloating.
Symptoms of Gastrointestinal Issues:
- Early satiety (feeling full after a little meal).
- Nausea and bloating.
- Difficulty swallowing (dysphagia), which can occur in the late stages of the disease.
Gastrointestinal Issues Management:
- Eating smaller, more frequent meals and avoiding high-fat or high-fiber foods can help with gastroparesis.
- Domperidone, a gastric motility stimulant, may be administered in extreme situations.
7. Fatigue
Fatigue is a disabling non-motor symptom of Parkinson’s disease that can arise in the absence of sleep difficulties. It might appear as physical fatigue, mental depletion, or a combination of the two.
Symptoms of Fatigue:
- Persistent fatigue, even after a full night’s sleep.
- Lack of energy and motivation to participate in regular tasks.
- Difficulty concentrating owing to extreme weariness.
Fatigue Management:
- Many Parkinson’s sufferers benefit from regular exercise, which boosts their energy and reduces weariness.
- Adjusting medication schedule or dosages may aid in regulating energy levels.
8. Psychosis and Hallucinations
Some people with advanced Parkinson’s disease may have psychosis, which includes hallucinations and delusions. Hallucinations are most commonly visual (seeing things that aren’t there), but they can also involve other senses like hearing or touch.
Symptoms of Psychosis and Hallucinations:
- Visual hallucinations: It involves seeing individuals or animals that are not present.
- Delusions: They are strong beliefs that are not rooted in reality, such as believing that someone is stealing or lying.
Psychosis and Hallucinations Management:
- Antipsychotic drugs, such as quetiapine or clozapine, may be used in severe cases.
- Reducing or modifying dopamine medicines may also help reduce the severity of hallucinations or psychosis.
While Parkinson’s disease is well known for its motor symptoms, the non-motor symptoms can be equally debilitating, affecting a variety of bodily systems. These non-motor symptoms are frequently underdiagnosed and undertreated, having a major influence on a patient’s quality of life.
Effective management of non-motor symptoms necessitates a multifaceted strategy that frequently includes drugs, lifestyle changes, and supporting therapies including physical and occupational therapy. Recognizing and addressing these symptoms early on can help persons with Parkinson’s disease feel better overall.
Jaslok Hospital, the best hospital for parkinson’s disease in Mumbai, offers comprehensive Parkinson’s disease care, addressing both motor and non-motor symptoms through cutting-edge treatments and tailored care plans. Our skilled team of the doctors is dedicated to improving patients’ quality of life via new therapies and compassionate care.
