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Erschienen in: Journal of Neural Transmission 8/2017

12.07.2017 | Neurology and Preclinical Neurological Studies - Review Article

Nonmotor fluctuations: phenotypes, pathophysiology, management, and open issues

verfasst von: Joseph Classen, Jiri Koschel, Christian Oehlwein, Klaus Seppi, Peter Urban, Christian Winkler, Ullrich Wüllner, Alexander Storch

Erschienen in: Journal of Neural Transmission | Ausgabe 8/2017

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Abstract

Parkinson’s disease (PD) is a neurodegenerative multisystem disorder characterized by progressive motor symptoms such as bradykinesia, tremor and muscle rigidity. Over the course of the disease, numerous non-motor symptoms, sometimes preceding the onset of motor symptoms, significantly impair patients’ quality of life. The significance of non-motor symptoms may outweigh the burden through progressive motor incapacity, especially in later stages of the disease. The advanced stage of the disease is characterized by motor complications such as fluctuations and dyskinesias induced by the long-term application of levodopa therapy. In recent years, it became evident that various non-motor symptoms such as psychiatric symptoms, fatigue and pain also show fluctuations after chronic levodopa therapy (named non-motor fluctuations or NMFs). Although NMFs have moved into the focus of interest, current national guidelines on the treatment of PD may refer to non-motor symptoms and their management, but do not mention NMF, and do not contain recommendations on their management. The present article summarizes major issues related to NMF including clinical phenomenology and pathophysiology, and outlines a number of open issues and topics for future research.
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Metadaten
Titel
Nonmotor fluctuations: phenotypes, pathophysiology, management, and open issues
verfasst von
Joseph Classen
Jiri Koschel
Christian Oehlwein
Klaus Seppi
Peter Urban
Christian Winkler
Ullrich Wüllner
Alexander Storch
Publikationsdatum
12.07.2017
Verlag
Springer Vienna
Erschienen in
Journal of Neural Transmission / Ausgabe 8/2017
Print ISSN: 0300-9564
Elektronische ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-017-1757-0

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