Non-Motor Symptoms of Parkinson's

Parkinson’s disease (PD) is typically characterized by motor (movement) symptoms. These symptoms include:1,2

  • Tremor at rest, such as a slight tremor in hands or feet
  • Rigidity (stiffness) of limbs, neck, or shoulders
  • Difficulty balancing (postural instability)
  • Slowness of movement or gradual loss of spontaneous movement (bradykinesia)

However, there are other symptoms of PD that are not directly related to movement dysfunction. These symptoms may be the first to appear, even before the more well-known movement symptoms.1,2

Possible symptoms

There are many possible non-motor symptoms of PD. Not everyone with PD will experience the same non-motor or motor symptoms. Symptoms may also differ in severity among different people. This is because PD is a highly variable disease, and each case progresses differently.1,2

Some possible non-motor symptoms include:1-3

  • Reduced sense of smell (hyposmia)
  • Gastrointestinal issues, such as constipation or slowed movement of food from the stomach into the intestines (gastroparesis)
  • Urinary issues, like a frequent and urgent need to urinate
  • A drop in blood pressure that occurs when standing (orthostatic hypotension)
  • Excessive drooling
  • Excessive sweating
  • Problems with sleep and wakefulness, including excessive daytime sleepiness, tiredness, REM sleep behavior (acting out dreams while asleep), or restless leg syndrome
  • Mood changes like depression or anxiety
  • Cognitive changes, including memory difficulties, slowed thinking, confusion, difficulty with planning, visual-spatial difficulties (like getting lost in a familiar place), or dementia
  • Psychotic symptoms, such as hallucinations, delusions, or paranoia
  • Sexual dysfunction, like erectile dysfunction in men or vaginal dryness in women
  • Pain, including nerve pain, pain due to prolonged twisting or muscle contractions (dystonia), discomfort due to restlessness, or bone, muscles, or tendon pain
  • Weight loss or weight gain
  • Vision problems, such as blurry vision, dry eyes, or difficulty opening eyes
  • Dental problems
  • Skin problems like dry skin, oily skin, dandruff, or excessive sweating
  • Impulsive behaviors, such as excessive shopping, unusual or increased sexual behavior, gambling, medicine abuse, or binge eating. Impulsive behaviors may be caused as a side effect of medicine and should be discussed with a doctor

Why do they occur?

Some of the non-motor symptoms of PD are a result of other changes in different areas of the brain outside of movement areas. Disruption of brain cells (neurons) in these other areas can cause problems with wakefulness and sleep, cognitive changes, and psychotic symptoms.

PD also affects a part of the body outside the brain called the autonomic nervous system (ANS). The ANS is the part of the nervous system that controls involuntary movement throughout the body. This means the ANS controls many of our organs and functions like breathing, heart rate, or digestion.4

PD can cause the nerve cells (neurons) in the ANS to become dysfunctional. If the ANS is not working properly, it can cause non-motor symptoms like those related to blood pressure, sweating, gastrointestinal issues, and sexual dysfunction. It is also possible that some medicines used to treat the motor symptoms of PD can worsen non-motor symptoms.4

How are they treated?

There is currently no known cure for PD. However, there are treatments that can help manage the symptoms. Most treatments of the non-motor symptoms are specific to the symptom.3,4

For example, there are medicines that can reduce an overactive bladder in people who experience urinary problems. Or, pain may be relieved through a combination of medicine, physical therapy, and exercise.3,4

Some non-motor symptoms, such as constipation, sleep problems, psychotic symptoms, or impulsive behaviors, may be caused as a side effect of or worsened by drugs used to treat the motor symptoms of PD.3,4

In this case, people may be able to work with their doctors to adjust their medicine or dose. Complementary therapies, such as acupuncture or massage, may also help relieve some non-motor symptoms of PD.3,4

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Written by: Juliette Daly | Last reviewed: November 2021