TREATMENT AND REHABILITATION IN NON-MOTOR SYMPTOMS OF PARKINSON'S DISEASE

Parkinson's disease (PD) is the second most common neurodegenerative disease. The cardinal clinical features of PD are motor and include bradykinesia, rigidity, and resting tremor with an asymmetric pattern. Apart from these, various nonmotor symptoms (NMS) also occur in PD and constitute a major clinical symptoms. NMS can present at any stage of the disease including early and pre-motor phase of PD. Management of PD requires recognition of both motor and nonmotor symptoms as well as an understanding of the relationship between these symptoms and how they can be affected by treatments for PD. Therapy should be individualized for each patient, as treatments for the motor symptoms of PD can improve some nonmotor symptoms while they can worsen others. Some non-motor symptoms, including depression, constipation, pain, genitourinary problems, and sleep disorders, can be improved with antiparkinsonian drugs. Other non-motor symptoms can be more refractory and need the introduction of novel non-dopaminergic drugs in association with rehabilitation programs. In the future, development of treatments that can slow or prevent the progression of Parkinson's disease and its multicentric neurodegeneration are the best hope of ameliorating non-motor symptoms