Management of Autonomic Dysfunction in Parkinson's Disease

Pfeiffer, Ronald F.

doi:10.1055/s-0037-1601568

Cited by 19 publications

(10 citation statements)

References 129 publications

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“…64 Despite the prominence and impact of these symptoms, there is no established evidence base for their treatment in LBD so opinion on best management is largely drawn upon the more established evidence base in PD. 8, 65,66…”

Section: Autonomic Dysfunctionmentioning

confidence: 99%

New evidence on the management of Lewy body dementia

Taylor

McKeith

Burn

et al. 2020

The Lancet Neurology

232

274

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Dementia with Lewy bodies and Parkinson's disease dementia, jointly known as Lewy body dementia (LBD), are common neurodegenerative conditions. Patients with LBD present with a wide range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. The expression of these varies between individual patients, and over time. Treatments may benefit one symptom, but at the expense of worsening another, making management difficult. Often symptoms are managed in isolation and by different specialists, which undermines high quality care.Clinical trials and meta-analyses now provide an improved evidence base for the treatment of cognitive, neuropsychiatric and motor symptoms in LBD, in addition to which expert consensus opinion supports the application of treatments from related conditions such as Parkinson's disease (PD) for the management of, for example, autonomic symptoms. There remain however clear evidence gaps and there is a high need for future clinical trials focused on specific symptoms in LBD.

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Section: Autonomic Dysfunctionmentioning

confidence: 99%

New evidence on the management of Lewy body dementia

Taylor

McKeith

Burn

et al. 2020

The Lancet Neurology

232

274

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“…The reported prevalence of decreased bowel movement frequency in PD varies from 20 to 77% [104] with a median constipation prevalence of 40 to 50% [105]. The physiological basis of constipation in PD is slowed transit of fecal material through the colon, which is evident in up to 80% of PD patients [106].…”

Section: Bowel Dysfunctionmentioning

confidence: 99%

Autonomic Dysfunction in Parkinson's Disease

Pfeiffer

2020

Neurotherapeutics

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Recognition of the importance of nonmotor dysfunction as a component of Parkinson's disease has exploded over the past three decades. Autonomic dysfunction is a frequent and particularly important nonmotor feature because of the broad clinical spectrum it covers. Cardiovascular, gastrointestinal, urinary, sexual, and thermoregulatory abnormalities all can appear in the setting of Parkinson's disease. Cardiovascular dysfunction is characterized most prominently by orthostatic hypotension. Gastrointestinal dysfunction can involve virtually all levels of the gastrointestinal tract. Urinary dysfunction can entail either too frequent voiding or difficulty voiding. Sexual dysfunction is frequent and frustrating for both patient and partner. Alterations in sweating and body temperature are not widely recognized but often are present. Autonomic dysfunction can significantly and deleteriously impact quality of life for individuals with Parkinson's disease. Because effective treatment for many aspects of autonomic dysfunction is available, it is vitally important that assessment of autonomic dysfunction be a regular component of the neurologic history and exam and that appropriate treatment be initiated and maintained.

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“…Autonomic dysfunction is an important non-motor phenotype of Parkinson's disease (6,7). Recently, an increasing number of studies have focused on the role of autonomic dysfunction in the prediction and early diagnosis of PD, making this one of the top research frontiers in the PD field [33,34,35,36].…”

Section: Autonomic Disturbances In Pdmentioning

confidence: 99%

The Motor Symptoms–challenge in Diagnosis of Parkinson's Disease

Marinova¹,

Danovska²

2020

JofIMAB

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Parkinson's disease (PD) is the second most common neurodegenerative disorder after the dementia of Alzheimer. The clinical presentation of PD is dominated by typical motor symptoms as resting tremor, cogwheel rigidity, bradykinesia, and postural instability. Non-motor symptoms (NMS) of Parkinson's disease are common but are often under-recognized in clinical practice either due to the lack of spontaneous complaints by the patients or to the absence of systematic questioning by healthcare professionals. In contrast to motor dysfunctions, non-motor symptoms frequently remain unreported. Recently, a self-completed NMS questionnaire and NMS scale for identification and evaluation of these symptoms have been validated. An international survey has shown that up to 62% of NMS in PD remain undeclared to healthcare professionals because patients are unaware that NMS symptoms are linked to PD. Based on both clinical and neuropathological data, PD, traditionally accepted as a dopaminergic motor disorder, now can be characterized as a multisystem neurodegenerative disease that involves many neurotransmitter systems and affects not only motor but non-motor functions, too.

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Management of Autonomic Dysfunction in Parkinson's Disease

Cited by 19 publications

References 129 publications

New evidence on the management of Lewy body dementia

New evidence on the management of Lewy body dementia

Autonomic Dysfunction in Parkinson's Disease

The Motor Symptoms–challenge in Diagnosis of Parkinson's Disease

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