Practice parameter

Treatment of nonmotor symptoms of Parkinson disease: Report of the quality standards subcommittee of the American academy of neurology

T. A. Zesiewicz, K. L. Sullivan, I. Arnulf, K. R. Chaudhuri, John Christopher Morgan, G. S. Gronseth, J. Miyasaki, D. J. Iverson, W. J. Weiner

Research output: Contribution to journalArticle

205 Citations (Scopus)

Abstract

Nonmotor symptoms (sleep dysfunction, sensory symptoms, autonomic dysfunction, mood disorders, and cognitive abnormalities) in Parkinson disease (PD) are a major cause of morbidity, yet are often underrecognized. This evidence-based practice parameter evaluates treatment options for the nonmotor symptoms of PD. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were previously reviewed as part of American Academy of Neurology practice parameters and were not included here. Methods: A literature search of MEDLINE, EMBASE, and Science Citation Index was performed to identify clinical trials in patients with nonmotor symptoms of PD published between 1966 and August 2008. Articles were classified according to a 4-tiered level of evidence scheme and recommendations were based on the level of evidence. Results and Recommendations: Sildenafil citrate (50 mg) may be considered to treat erectile dysfunction in patients with Parkinson disease (PD) (Level C). Macrogol (polyethylene glycol) may be considered to treat constipation in patients with PD (Level C). The use of levodopa/carbidopa probably decreases the frequency of spontaneous nighttime leg movements, and should be considered to treat periodic limb movements of sleep in patients with PD (Level B). There is insufficient evidence to support or refute specific treatments for urinary incontinence, orthostatic hypotension, and anxiety (Level U). Future research should include concerted and interdisciplinary efforts toward finding treatments for nonmotor symptoms of PD

Original languageEnglish (US)
Pages (from-to)924-931
Number of pages8
JournalNeurology
Volume74
Issue number11
DOIs
StatePublished - Mar 16 2010

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Neurology
Parkinson Disease
Therapeutics
Sleep
Sialorrhea
Orthostatic Hypotension
Botulinum Toxins
Evidence-Based Practice
Urinary Incontinence
Erectile Dysfunction
Constipation
Mood Disorders
MEDLINE
Leg
Extremities
Anxiety
Clinical Trials
Morbidity

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Practice parameter : Treatment of nonmotor symptoms of Parkinson disease: Report of the quality standards subcommittee of the American academy of neurology. / Zesiewicz, T. A.; Sullivan, K. L.; Arnulf, I.; Chaudhuri, K. R.; Morgan, John Christopher; Gronseth, G. S.; Miyasaki, J.; Iverson, D. J.; Weiner, W. J.

In: Neurology, Vol. 74, No. 11, 16.03.2010, p. 924-931.

Research output: Contribution to journalArticle

Zesiewicz, TA, Sullivan, KL, Arnulf, I, Chaudhuri, KR, Morgan, JC, Gronseth, GS, Miyasaki, J, Iverson, DJ & Weiner, WJ 2010, 'Practice parameter: Treatment of nonmotor symptoms of Parkinson disease: Report of the quality standards subcommittee of the American academy of neurology', Neurology, vol. 74, no. 11, pp. 924-931. https://doi.org/10.1212/WNL.0b013e3181d55f24
Zesiewicz, T. A. ; Sullivan, K. L. ; Arnulf, I. ; Chaudhuri, K. R. ; Morgan, John Christopher ; Gronseth, G. S. ; Miyasaki, J. ; Iverson, D. J. ; Weiner, W. J. / Practice parameter : Treatment of nonmotor symptoms of Parkinson disease: Report of the quality standards subcommittee of the American academy of neurology. In: Neurology. 2010 ; Vol. 74, No. 11. pp. 924-931.
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