Non-pharmacological treatment challenges in early Parkinson's disease for axial and cognitive symptoms : A mini review
Journal article
Constantinescu-Sharpe, Gabriella, Macerollo, Antonella, Fabbri, Margherita and Tripoliti, Elina. (2020). Non-pharmacological treatment challenges in early Parkinson's disease for axial and cognitive symptoms : A mini review. Frontiers in Neurology. 11, p. 576569. https://doi.org/10.3389/fneur.2020.576569
Authors | Constantinescu-Sharpe, Gabriella, Macerollo, Antonella, Fabbri, Margherita and Tripoliti, Elina |
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Abstract | Background: Parkinson's disease (PD) is now known to be a multisystemic heterogeneous neurodegenerative disease, including a wide spectrum of both motor and non-motor symptoms. PD patients' management must encompass a multidisciplinary approach to effectively address its complex nature. There are still challenges in terms of treating axial (gait, balance, posture, speech, and swallowing) and cognitive symptoms that typically arise with disease progression becoming poorly responsive to dopaminergic or surgical treatments. Objective: The objectives of the study are to further establish the presentation of axial and cognitive symptoms in early PD [Hoehn and Yahr (H&Y) scale ≤ 2] and to discuss the evidence for non-pharmacological approaches in early PD. Results: Mild and subtle changes in the investigated domains can be present even in early PD. Over the last 15 years, a few randomized clinical trials have been focused on these areas. Due to the low number of studies and the heterogeneity of the results, no definitive recommendations are possible. However, positive results have been obtained, with effective treatments being high-intensity treadmill and cueing for gait disturbances, high-intensity voice treatment, video-assisted swallowing therapy for dysphagia, and warm-up exercises and Wii FitTM training for cognition. Conclusions: Considering the association of motor, speech, and cognitive function, future trials should focus on multidisciplinary approaches to combined non-pharmacological management. We highlight the need for a more unified approach in managing these “orphan” symptoms, from the very beginning of the disease. The concept “the sooner the better” should be applied to multidisciplinary non-pharmacological management in PD. |
Keywords | early Parkinson’s disease; speech; swallowing; axial symptoms; cognition; multidisciplinary care |
Year | 2020 |
Journal | Frontiers in Neurology |
Journal citation | 11, p. 576569 |
Publisher | Frontiers Research Foundation |
ISSN | 1664-2295 |
Digital Object Identifier (DOI) | https://doi.org/10.3389/fneur.2020.576569 |
Scopus EID | 2-s2.0-85092523447 |
Research or scholarly | Research |
Page range | 1-11 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 25 Sep 2020 |
Publication process dates | |
Accepted | 17 Aug 2020 |
Deposited | 12 Jul 2021 |
https://acuresearchbank.acu.edu.au/item/8w599/non-pharmacological-treatment-challenges-in-early-parkinson-s-disease-for-axial-and-cognitive-symptoms-a-mini-review
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Publisher's version
OA_Sharpe_2020_Non_pharmacological_treatment_challenges_in_early.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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