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A more widespread use of questionnaires and scales such as n on-motor symptoms ( NMS)-Quest and the n on-motor symptoms scale (NMSS ) has confirmed that NMS, such as sleeping difficulties and speech problems, are at least as troublesome for Parkinson’s disease patients as the major motor symptoms. These NMS can have a profound negative effect on patient quality of life and on the health of the person providing care. This fact is now receiving more attention in clinical practice and measures are being taken to improve the recognition and treatment of NMS, and to provide better support for care-givers. As our knowledge base of NMS expands, we are increasingly finding that some of them, e.g. olfactory deficit and rapid eye movement (REM) sleep behaviour disorder, also occur early in Parkinson’s disease, possibly pre-dating a diagnosis based on motor signs alone.

Redressing the Balance in Parkinson’s Disease Management with a Greater Focus on Non-motor Symptoms and Care-giver Health