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A narrative literature review was conducted across multiple databases and journals to summarize the most common NMSs, their clinical presentation, social impact, diagnosis, and therapeutic management. Early recognition supports more timely, effective care and improves understanding of patient needs.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/non-motor-symptoms-the-hidden-face-of-parkinsons-disease/464902/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/non-motor-symptoms-the-hidden-face-of-parkinsons-disease/464902.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are non-motor symptoms important in Parkinson’s disease?","Question",{"text":112,"@type":113},"Non-motor symptoms are considered integral to PD and significantly contribute to deterioration of patients’ quality of life. 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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Medical Department, Zambon SpA, 20091 Bresso, Italy  \n2 Neurology Department, San Giovanni Hospital, 00153 Rome, Italy; [fabbriniandrea89@gmail.com](fabbriniandrea89@gmail.com)  \n3 Department Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy;  \ndaniele.belvisi@uniroma1.it (D.B.); flavia.aiello@uniroma1.it (F.A.); giovanni.fabbrini@uniroma1.it (G.F.)  \n4 Neurology Department, IRCSS Neuromed, 86077 Pozzilli, Italy; [francesco.marchet@uniroma1.it](francesco.marchet@uniroma1.it)  \n* Correspondence: [carlo.cattaneo@zambongroup.com](carlo.cattaneo@zambongroup.com)  \nAbstract  \nNon-motor symptoms (NMSs) of Parkinson’s disease (PD) were recognized by James Parkinson himself about 200 years ago and are now considered to be an integral part of PD, significantly contributing to the deterioration of patients’ quality of life. Although awareness of NMSs is growing, and several scientific societies now have dedicated nonmotor study groups, the NMS burden is still the hidden face of PD and in most cases, clinicians’ views are focused on the motor symptoms alone. The literature was reviewed using several databases and scientific journals; this review provides a comprehensive description of the most common NMSs in PD, their clinical phenotype, social impact, diagnosis, and therapeutic management. Early recognition of these features may lead to more prompt and effective treatment and may help to better understand patients’ needs.  \nKeywords: Parkinson’s disease; non-motor symptoms; quality of life; management  \n1. Introduction  \nParkinson’s disease (PD) is a degenerative disorder of the central nervous system (CNS), typically characterized by a triad of motor symptoms, namely hypokinesia/bradykinesia, rigidity, and tremor, caused by a striatal deficiency of the neurotransmitter dopamine [1] . As such, current treatment of PD is based on the replacement of dopamine. While this can offer good control of motor symptoms, it does not halt the progression of neurodegeneration and consequent disability [1] . Globally, PD affects around six million people, and this number continues to increase due to numerous factors, including an ageing population, environmental factors, and a longer disease duration [2] . PD also presentsa significant economic burden; in 2017, the estimated total medical cost attributable to this pathology was just over USD 25 billion in the United States alone [3] . As well as the cardinal motor symptoms of PD, there are also so-called non-motor symptoms (NMSs), including a wide variety of manifestations such as autonomic dysfunctions, hyposmia, sleep problems, neuropsychiatric symptoms, and cognitive impairment [4] . Patients often indicate that their NMSs are more difficult to manage than their motor problems [5]; the UK National Institute for Health and Care Excellence (NICE) recognizes NMSs and their management, as an important area of unmet need in PD [6] . However, a 2019 cross-sectional study found that up to 72% of people with PD do not report NMS to their healthcare professional [7] . The most commonly reported barriers to seeking help were acceptance of the symptoms, a lack of awareness that the symptom was associated with PD, and embarrassment to  \ndiscuss some symptoms such as sexual problems or incontinence [7] . Clinicians often fail to identify NMSs during consultations, due to lack of time, a focus on motor aspects of PD, and t","cbCaiemgrE2sXK4T","https://ap.wps.com/l/cbCaiemgrE2sXK4T","pdf",552492,36,"English","# Abstract\n# Introduction\n## Epidemiology","[{\"question\":\"Why are non-motor symptoms important in Parkinson’s disease?\",\"answer\":\"Non-motor symptoms are considered integral to PD and significantly contribute to deterioration of patients’ quality of life. Clinicians often focus mainly on motor symptoms, leaving the NMS burden inadequately addressed.\"},{\"question\":\"How was the literature reviewed in this publication?\",\"answer\":\"The review used a narrative search across PubMed, Cochrane, and Google Scholar to identify relevant publications on NMS epidemiology, clinical features, and treatments. MeSH keywords were applied, and selected studies were prioritized, especially recent literature.\"},{\"question\":\"What does the publication report about the prevalence of NMSs?\",\"answer\":\"Data from validated questionnaires show that NMSs are highly prevalent in PD. In one group of more than 2500 patients, almost all reported multiple symptoms, and similar findings were confirmed using a movement disorder–specific NMS scale.\"}]","Non-Motor Symptoms - The Hidden Face of Parkinson’s Disease | PDF",1790768885,91]