Journal of Neurology

, Volume 258, Issue 8, pp 1513–1517 | Cite as

How well do we recognise non-motor symptoms in a British Parkinson’s disease population?

  • Michele Hu
  • Jonathan Cooper
  • Rebecca Beamish
  • Emma Jones
  • Richard Butterworth
  • Lesley Catterall
  • Yoav Ben-Shlomo
Original Communication


Although awareness of non-motor symptoms in Parkinson’s disease (PD) has recently increased, little is known about their recognition and treatment in routine clinical practice. We therefore applied non-motor rating scales for dementia, depression, anxiety and excessive daytime sleepiness to a community-ascertained cohort of 202 PD patients. Hospital case notes were reviewed for evidence that the non-motor problems had been recognized and whether any action had been taken to ameliorate or assess these symptoms. The prevalence of each non-motor problem was as follows: dementia 25.3% (95% CI 19.0, 32.4), depression 37.3% (95% CI 30.6, 44.4), anxiety 31.3% (95% CI 25.0, 38.2), excessive daytime sleepiness 59.4% (95% CI 52.2, 66.3). However, these features were only recognised in 27.2, 38.7, 9.5, and 12.8%, respectively. We did not identify any specific factor that predicted under-recognition. Our study shows that when rating scales are applied to formally assess for non-motor symptoms a large clinical ‘iceberg effect’ emerges with the majority of symptoms going unrecognised and untreated.


Parkinson’s disease Non-motor symptoms Recognition 


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Michele Hu
    • 1
    • 6
  • Jonathan Cooper
    • 2
  • Rebecca Beamish
    • 2
  • Emma Jones
    • 3
  • Richard Butterworth
    • 1
  • Lesley Catterall
    • 4
  • Yoav Ben-Shlomo
    • 5
  1. 1.Department of NeurologyMilton Keynes Hospital NHS Foundation Trust and Oxford Radcliffe HospitalsOxfordUK
  2. 2.Department of General MedicineMilton Keynes Hospital NHS Foundation TrustMilton KeynesUK
  3. 3.Milton Keynes Neuro-Rehabilitation UnitMilton KeynesUK
  4. 4.Thames Valley Dementia and Neurodegenerative Diseases Research Network (DeNDRoN)OxfordUK
  5. 5.Department of Social MedicineUniversity of BristolBristolUK
  6. 6.Department of Clinical NeurologyLevel 3, West Wing, John Radcliffe HospitalOxfordUK

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