The term Parkinson’s disease has been changed in ‘Parkinson's diseases’ to describe different clinical entities
observed in several studies investigating the existence of PD subtypes. PD patients could be grouped based on clinical features.
By considering only motor symptoms, we can classically distinguish two groups: “ the tremorigen-form” and “akinetic-
rigidity-form” where resting tremor and akinesia/bradikynesia and rigidity are the most motor predominant symptoms,
respectively. Non-motor symptoms (NMSs) are practically always present during the course of the disease and some
of them (constipation, depressive status, hyposmia and anxiety) could even exist before the onset of classical motor symptoms.
Many other NMSs and in particular hallucinations, cognitive impairment, sleep disorders and difficulty in swallowing
strongly affect the advanced stage of disease, and represent a real therapeutic challenge when these symptoms are simultaneously
present with different severity. If not adequately treated, they can increase the risk of hospitalization and
admissions in nursing home, and profoundly and negatively influence the quality of life and participation in social activity
of these patients. PD subtypes according to the combination of motor and non-motor symptoms have been recently proposed.
This classification derives from cluster analysis which permits to identify statistically distinct subtypes of Parkinsonian
patients according to the relevance of both motor and non-motor symptoms. In this point of view, we propose a
schematic therapeutic approach of motor and non-motor symptoms in Parkinson’s disease according to cluster symptoms
presentation (motor and non-motor symptoms) and using medications that act on multiple domains of PD symptoms.
Keywords: Cluster symptoms, motor symptoms, non-motor symptoms, Parkinson’s disease, subtypes, treatment.
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