J Mov Disord.
2025 Jan;18(1):1-16. 10.14802/jmd.24227.
Non-Motor Fluctuations in Parkinson’s Disease: Underdiagnosed Yet Important
- Boura I
1,2,3 - Poplawska-Domaszewicz K3,4
- Spanaki C1,5
- Chen R2,3
- Urso D2,3,6
- Coller Rv7
- Storch A8,9
- Chaudhuri KR2,3
- Affiliations
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- 1School of Medicine, University of Crete, Heraklion, Greece
- 2Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- 3Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London, UK
- 4Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
- 5Neurology Department, University General Hospital of Heraklion, Crete, Greece
- 6Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
- 7Department of Neurology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- 8Department of Neurology, University of Rostock, Rostock, Germany
- 9German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
- KMID: 2564041
- DOI: http://doi.org/10.14802/jmd.24227
Abstract
- Non-motor fluctuations (NMFs) in Parkinson’s disease (PD) significantly affect patients’ well-being. Despite being identified over two decades ago, NMFs remain largely underrecognized, undertreated, and poorly understood. While they are often temporally associated with motor fluctuations (MFs) and can share common risk factors and pathophysiologic mechanisms, NMFs and MFs are currently considered distinct entities. The prevalence and severity of NMFs, often categorized into neuropsychiatric, sensory, and autonomic subtypes, vary significantly across studies due to the heterogeneous PD populations screened and the diverse evaluation tools applied. The consistent negative impact of NMFs on PD patients’ quality of life underscores the importance of further investigations via focused and controlled studies, validated assessment instruments and novel digital technologies. High-quality research is essential to illuminate the complex pathophysiology and clinical nuances of NMFs, ultimately enhancing clinicians’ diagnostic and treatment options in routine clinical practice.
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