non-motor symptoms in parkinson’s · parkinson’s disease •pd is considered a movement...
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Joseph H. Friedman, MD
Stanley Aronson Chair in
Neurodegenerative Disorders
Director, Movement Disorders Program
Butler Hospital
Dept of Neurology
Alpert Medical School of Brown
University
Non-Motor Symptoms in Parkinson’s
Disease 2020
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CONFLICTS OF INTEREST
•None relevant to this talk
•Medlink; Karger Press;
Cambridge University Press;
Concert Pharma
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PARKINSON’S DISEASE
• PD is considered a movement disorder
BUT
It is really a movement and behavioral disorders with
autonomic problems
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NON-MOTOR SYMPTOMS
• Somatic• Constipation
• Blood pressure
• Bladder
• Sweating
• Pain
• Skin
• Breathing
• Runny nose
•Behavior• Depression
• Anxiety
• Fatigue
• Sleep
• Hallucinations
• Dementia
• Compulsivity
• Apathy
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PAIN
•PD patients have more pain
•Due to ”usual” problems
•Due to PD itself
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AUTONOMIC PROBLEMS
• What is the autonomic nervous
system?
• It controls unconscious processes
• Blood pressure
• Bowels
• Bladder
• Sweating
• Heart rate
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ORTHOSTATIC HYPOTENSION
• Drop in blood pressure on standing up
• Leads to lightheadedness, faints and
falls.
• Often with supine (lying down) high
blood pressure
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DEMENTIA
• Decline in memory and thinking
• Different than Alzheimer’s disease
• Associated with other behavior
problems
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DEPRESSION AND APATHY
•Depression
• Sad, blue, lack of enjoyment
• Irritable; sleep disturbances
•Apathy
• Lack of motivation
• Lack of emotion
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Visual and
tactile
hallucininat
ion
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HALLUCINATIONS AND DELUSIONS
•Hallucinations
•Visual, auditory, tactile, smell,
taste
• Sense of “presence”
•Delusions
• False beliefs
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ICD Interview on gamblingICD Interview on gambling
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COMPULSIVE BEHAVIORS
• Often labelled as ICD (impulse control disorders)
Gambling
Hypersexuality
Hobbyism
Collecting
Binge eating
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COMPULSIVE BEHAVIORS
• Often labelled as ICD (impulse control disorders)
Gambling
Hypersexuality
Hobbyism
Collecting
Binge eating
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end