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Abstract

Background: Non-motor symptoms (NMS) are an important and ubiquitous determinantof quality of life in Parkinson’s disease (PD). However, robust evidence for their treatment is still amajor unmet need.

Objective: This study aimed to provide an updated review on advances in pharmacological, nonpharmacological,and exercise-based interventions for NMS in PD, covering the period since thepublication of the MDS Task Force Recommendations.

Methods: We performed a literature search to identify pharmacological, non-pharmacological, andexercise-based interventions for NMS in PD. As there are recent reviews on the subject, we haveonly included studies from the 1st of January 2017 to the 1st of December 2021 and limited oursearch to randomised and non-randomised (including open-label) clinical trials.

Results: We discuss new strategies to manage NMS based on data that have become available since2017, for instance, on the treatment of orthostatic hypotension with droxidopa, several dopaminergictreatment options for insomnia, and a range of non-pharmacological and exercise-based interventionsfor cognitive and neuropsychiatric symptoms, pain, and insomnia and excessive sleepiness.

Conclusion: Recent evidence suggests that targeted non-pharmacological treatments, as well assome other NMS management options, may have a significant beneficial effect on the quality of lifeand need to be considered in the pathways of treatment of PD.

Keywords:Parkinson's disease, non-motor symptoms, autonomic symptoms, neuropsychiatric symptoms, pain, treatment, nonpharmacological treatment.

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DOI https://dx.doi.org/10.2174/1570159X20666220315163856	Print ISSN 1570-159X
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