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Chapter 3 - Non-Motor Symptoms in Late-Stage Parkinson’s Disease

Published online by Cambridge University Press:  05 March 2022

Néstor Gálvez-Jiménez
Affiliation:
Florida International University
Amos D. Korczyn
Affiliation:
Tel-Aviv University
Ramón Lugo-Sanchez
Affiliation:
Cleveland Clinic
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Summary

Late-stage Parkinson’s disease (PD) poses a significant challenge to clinicians. In addition to this, there is a lack of clarity in even its terminology and definition. It has been termed as advanced, late-stage, end-stage, and even palliative PD [1–3]. As the term late-stage PD has become the most widespread, it will be used henceforth. The criteria for diagnosing late-stage PD too has varied, with initial literature using varying cut-offs of the Hoehn and Yahr (H&Y) staging to determine the degree of advancement [1–3]. There has been significant criticism to this approach; it was asserted that while H & Y is heavily weighted towards postural instability and lower limb problems, it may overlook other motor symptoms that contribute to the advancing state, and it excludes non-motor symptoms (NMS). It was also written with the assumption that severity of PD is most related to motor symptoms [4].

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Publisher: Cambridge University Press
Print publication year: 2022

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References

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