Parkinson's disease - non-motor symptoms

Posted by Master, Doctor Nguyen Thi Minh Phuong - Department of General Internal Medicine - Vinmec Times City International Hospital

Non-motor symptoms are symptoms that do not affect the patient's movement, including:
Decreased or lost sense of smell Sleep disorders Emotional disorders such as depression Constipation problems urinating ( Frequent urination) Fluctuating blood pressure, heart rate Pain syndrome Cognitive disorders And other symptoms...

Of the above symptoms, there are 4 symptoms that appear most early: decreased sense of smell, sleep disturbance, constipation and depression. These symptoms can appear years, sometimes decades, before the person has motor symptoms. However, these are also common symptoms in many people in society and do not necessarily develop into Parkinson's disease. Therefore, doing tests for early screening will cost a lot and cause unnecessary anxiety for patients. But once the patient develops additional motor symptoms, the likelihood of Parkinson's disease is much higher.

In patients with Parkinson's disease, an abnormal deposition of proteins, alpha-synuclein is found in nerve cells in the lower regions of the brain stem. These deposits form clumps called Lewy bodies. It is hypothesized that these Lewy bodies were initially concentrated in the lower part of the brain stem, where the autonomic nervous system (constipation, hypotension, etc.) emotional coordination.
Gradually, the degenerative process spreads to the midbrain, which governs abnormal movements such as muscle stiffness, hand tremors at rest, reduced movement. This hypothesis explains why non-motor symptoms precede motor symptoms. Recently, Lewy bodies have been found in the sympathetic ganglia, the neuromuscular plexus, the cerebral cortex, the limbic system, the activating reticular system, the olfactory nerve, the cranial nerve nucleus X... suggests that Parkinson's disease should be considered a systemic disease that affects both the central and peripheral nervous systems.

When there are early non-motor symptoms of Parkinson's such as loss of smell, constipation, depression or insomnia, you and your loved one may worry and wonder if you will develop Parkinson's disease in the future. You can visit a neurologist for examination and advice.
If the doctor does not detect any early motor symptoms of Parkinson's disease, such as discreet tremors in one arm, stiffness in limbs, slightly stooped gait, sluggishness, decreased blinking or decreased facial expressions. .. then you shouldn't be too worried. There are currently no recommendations that allow a DaTscan to detect decreased levels of dopamine in the brain in individuals with mere nonmotor symptoms. Similarly, no neuroprotective drug has been shown to prevent or slow the development of Parkinson's disease. As a result, your doctor will likely prescribe treatment for your symptoms, and make an annual appointment to continue monitoring and detect motor symptoms early.
However, to date there is scientific evidence indicating that exercise has a neuroprotective effect and may influence the progression of Parkinson's disease. So for those who have only symptoms of inactivity, consulting and discussing with a doctor about starting exercise or increasing the level of exercise will be an option.

Points to keep in mind:
The first symptoms of Parkinson's disease are often unrelated to movement. Nonmotor symptoms associated with Parkinson's disease are common in society (many people may have them but not progress to Parkinson's disease). Non-motor symptoms are considered to be in Parkinson's disease only when at least one additional motor symptom is present. If you are concerned about any motor or nonmotor symptoms that may be associated with Parkinson's disease, see a neurologist. Regular exercise has a neuroprotective effect and may alter the progression of Parkinson's disease. So start exercising immediately after discussing it with your doctor. Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in medical examination and treatment, patients can rest assured to visit. and hospital treatment.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.

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