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- Review Article Non-motor fluctuations in Parkinson’s disease: underdiagnosed, yet important
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Iro Boura1,2,3, Karolina Poplawska-Domaszewicz3,4, Cleanthe Spanaki1,5, Rosabel Chen2,3, Daniele Urso2,3,6, Riaan van Coller7, Alexander Storch8,9, Kallol Ray Chaudhuri2,3
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DOI: https://doi.org/10.14802/jmd.24227 [Accepted]
Published online: December 20, 2024
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1School of Medicine, University of Crete, Heraklion, Greece
2Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
3Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London, UK
4Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
5Neurology Department, University General Hospital of Heraklion, Crete, Greece
6Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
7Department of Neurology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
8Department of Neurology, University of Rostock, Rostock, Germany
9German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
2Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
3Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London, UK
4Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
5Neurology Department, University General Hospital of Heraklion, Crete, Greece
6Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
7Department of Neurology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
8Department of Neurology, University of Rostock, Rostock, Germany
9German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
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Corresponding author:
Kallol Ray Chaudhuri,
Email: chaudhuriray@hotmail.com
Received: 13 November 2024 • Revised: 12 December 2024 • Accepted: 20 December 2024
Iro Boura and Karolina Poplawska-Domaszewicz contributed equally to this study as co-first authors.
Iro Boura and Karolina Poplawska-Domaszewicz contributed equally to this study as co-first authors.
Abstract
Non-motor fluctuations (NMF) in Parkinson's disease (PD) significantly affect patients’ well-being. Despite being identified over two decades ago, NMF remain largely under-recognized, under-treated, and poorly understood. While they are often temporally associated with motor fluctuations (MF) and can share common risk factors and pathophysiologic mechanisms, NMF and MF are currently considered distinct entities. The prevalence and severity of NMF, often categorized into neuropsychiatric, sensory, and autonomic subtypes, vary significantly across studies due to the heterogeneous PD populations screened and the diverse evaluation tools applied. The consistent negative impact of NMF on PD patients’ quality of life (QoL) underscores the importance of further investigation via focused and controlled studies, validated assessment instruments and novel digital technologies. High-quality research is essential to illuminate the complex pathophysiology and clinical nuances of NMF, ultimately enhancing clinicians’ diagnostic and treatment options in routine clinical practice.
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