Researcbers Discover More Nonmotor Symptoms of Parkinson Disease
Tuesday, October 14th, 2008Background
Previous research has shown that symptoms of Parkinson disease (PD) include more than just motor symptoms–they also include nonmotor symptoms. Quite a bit of research has identified problems with digestion, urination, anxiety, depression, and sexual function–all related to PD. Sometimes these nonmotor symptoms appear before the classic symptoms of PD.
Scientists and doctors are continuing their search for other nonmotor symptoms that are linked with PD. Recent research has identified two previously unreported nonmotor symptoms of PD.
What did the first research show?
The first was a report about two patients with PD who had a symptom called phantosmia. Phantosmia is a unique condition in which the person smells something that is not truly present in his or her environment. Medical specialists also call this an olfactory hallucination.
The olfactory bulb and tracts
are shown in red in this
1543 sketch by Vesalius.
Although previous research has shown that some people with PD lose their sense of smell (called anosmia) or have a distorted sense of smell (called parosmia), no previous reports have been published about people with PD having phantosmia. Phantosmia has, however, been reported to occur in people with a certain type of seizures, a brain injury, Alzheimer disease, or, rarely, migraine.
Both of the people in this report described the smells as a type of perfume. They said that the scent was not related to one specific situation or place and was linked with positive experiences. People who have phantosmia associated with other disorders, such as seizures or a brain injury, often experience unpleasant smells that are related to negative experiences. The phantosmia episodes in the two patients in this report lasted for anywhere from a few minutes to half an hour.
Both people developed phantosmia before any other symptom of PD was present, and both soon developed classic symptoms of PD. Although disordered sense of smell is quite common in PD and in other disorders, how often phantosmia occurs is not known. No one is sure how often people with phantosmia are later diagnosed with PD because many people, including doctors and researchers, don’t know about phantosmia as a nonmotor symptom of PD.
Landis BN, Burkhard PR. Phantosmias and Parkinson disease. Arch Neurol 2008;65(9)1237-1239.
What did the second research find?
These researchers compared pain levels in people with PD with pain levels in a group of people who were the same age and did not have PD (called the control group). They found that people with PD had more pain than those in the control group.
The increased level of pain in the group with PD was related to the fact that the people with PD had pain caused by dystonia, and the people in the control group did not have dystonia. Pain that was not caused by dystonia was similar between people in the two groups. Even when they first began having symptoms of PD, the PD group had more pain than the control group.
The researchers found that, in addition to having more pain, the people with PD experienced pain differently than did people without PD. People with PD had pain in different parts of their body, such as in their back, shoulders, or legs. People with PD also had different types of pain, including cramping.
Defazio G, Alfredo Berardelli A, Fabbrini G. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol 2008;65(9):1191-1194.
What does this research mean for people with PD?
This recent research shows that there are many different types of nonmotor symptoms in PD. Sometimes these types of symptoms can appear before the motor symptoms that are typically associated with PD appear. Pain and phantosmia are just two of numerous symptoms associated with PD. Doctors, researchers, and people with PD continue to work on understanding all of the effects of this disease. As more research is done in this area, the hope is that doctors will be more aware of these nonmotor symptoms and better able to recognize and treat PD.
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