@article{fddedb20d5b94ec689c4d2308a5db066,
title = "Practice parameter: Treatment of nonmotor symptoms of Parkinson disease: Report of the quality standards subcommittee of the American academy of neurology",
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",
author = "Zesiewicz, {T. A.} and Sullivan, {K. L.} and I. Arnulf and Chaudhuri, {K. R.} and Morgan, {J. C.} and Gronseth, {G. S.} and J. Miyasaki and Iverson, {D. J.} and Weiner, {W. J.}",
note = "Funding Information: Dr. Zesiewicz has received funding for travel from and served on speakers' bureaus for Boehringer Ingelheim and Teva Pharmaceutical Industries Ltd.; and receives research support from Boehringer Ingelheim, Novartis, GlaxoSmithKline, UCLA-RAND, Teva Neuroscience, Pfizer Inc, Allergan, Inc., the National Ataxia Foundation, Friedreich's Ataxia Research Association, and from the Bill Allison Ataxia Research Center. Ms. Sullivan reports no disclosures. Dr. Arnulf has served on scientific advisory boards for UCB and BioProject Pharma; has received funding for travel from UCB and for educational activities not funded by industry; received speaker honoraria from UCB and AstraZeneca; and has received research support UCB and BioProject Pharma. Dr. Chaudhuri serves on scientific advisory boards for Solvay Pharmaceuticals, Inc., Boehringer Ingelheim, GlaxoSmithKline, Merck Serono, Teva Pharmaceutical Industries Ltd.; serves on the editorial board of Parkinson's Disease and Related Disorders ; receives research support from UCB, SCHWARZ PHARMA, Boehringer Ingelheim, Britannia Pharmaceuticals, and Solvay Pharmaceuticals, Inc.; and estimates that 10% of his clinical effort is administering botulinum toxin for dystonia. Dr. Morgan serves on a scientific advisory board for Boehringer Ingelheim; serves on speakers' bureaus for Boehringer Ingelheim, GlaxoSmithKline, Teva Pharmaceutical Industries Ltd., Novartis, and SCHWARZ PHARMA; and receives research support from Boehringer Ingelheim, GlaxoSmithKline, UCB, Teva Pharmaceutical Industries Ltd., Novartis, ACADIA Pharmaceuticals, Santhera Pharmaceuticals, the NIH (NET-PD LS-1 [sub-investigator]), and from the National Parkinson Foundation. Dr. Gronseth serves as an editorial advisory board member of Neurology Now ; serves on a speakers' bureau for Boehringer Ingelheim; and receives honoraria from Boehringer Ingelheim and the American Academy of Neurology. Dr. Miyasaki has served on a scientific advisory board for Teva Pharmaceutical Industries Ltd.; has received honoraria for educational activities not funded by industry; serves on the editorial board of Movement Disorders ; has received speaker honoraria from Biovail Corporation; serves/has served as a consultant to Ortho-McNeil-Janssen Pharmaceuticals, Inc., Merz Pharmaceuticals, LLC, Schering-Plough Corp., the NIH (Independent Medical Monitor), Ontario Drug Benefits, and Common Drug Review, Canada; and receives research support from Teva Pharmaceutical Industries Ltd., Boehringer Ingelheim, Solvay Pharmaceuticals, Inc., Solstice Neurosciences, Inc., Impax Laboratories, Neurogen, Medivation, Inc., the National Parkinson Foundation, the Parkinson Society Canada, the Michael J Fox Foundation, and the Huntington Study Group. Dr. Iverson reports no disclosures. Dr. Weiner has served on scientific advisory boards for Santhera Pharmaceuticals, Boehringer Ingelheim, Novartis, GlaxoSmithKline, and Teva Pharmaceutical Industries Ltd.; serves as Editor of Current Treatment Options in Neurology and on the editorial board of Parkinsonism and Related Disorders ; receives royalties from the publication of Parkinson's Disease: A Complete Guide for Patients and Families (The Johns Hopkins University Press, 2001), Parkinson's Disease: Diagnosis and Clinical Management (Demos Medical Publishing, Inc., 2002), and Neurology for the Non-Neurologist 5th ed. (Lippincott Williams & Wilkins, 2004); and has received research support from Santhera Pharmaceuticals, Boehringer Ingelheim, and Teva Pharmaceutical Industries Ltd. ",
year = "2010",
month = mar,
day = "16",
doi = "10.1212/WNL.0b013e3181d55f24",
language = "English (US)",
volume = "74",
pages = "924--931",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "11",
}