Abstract Introduction

Parkinson’s disease (PD) is a neurodegenerative disorder with progressive motor and non-motor symptoms (NMS). Motor symptoms are more recognizable and easily assessed using a standardized scale for Movement Disorders. However, NMS has a significant role in affecting patients’ quality of life, typically precedes motor symptoms, and can cause functional and cognitive deterioration in the long term.  

This article reviews the neuropathological basis, classification, and management of NMS in PD, considering clinical experience and using data from PD clinical trials.  

This article aims to revisit the diagnostic understanding, neuropathological mechanisms, symptoms’ complex presentation, practical management options, and discussion of future emerging therapies.  

The management of NMS in PD requires a multifaceted approach, addressing each symptom with tailored interventions. Early identification and treatment of NMS can significantly improve the overall well-being of PD patients. This article highlights the importance of a comprehensive management plan that includes pharmacological and non-pharmacological strategies. The author recommends reviewing the existing model of care and considering a novel approach to starting an integrated movement assessment program targeting assessment for non-motor symptoms and implementing a multidisciplinary evaluation and recommendations to bridge the gap between primary care physicians and neurologists. (Integrated Movement assessment program – Illawarra and Shoalhaven local health district).

The author has identified significant variability in the presentation of nonmotor symptoms with Movement disorders and emphasizes the importance of a better understanding of neuropathological mechanisms, early detection, diagnosis, and implementation management to minimize disease burden and disabilities.

Dr. Vaidya Bala is an experienced and highly qualified Rehabilitation Physician with extensive expertise in the assessment and management of various conditions, including traumatic brain injury, musculoskeletal disorders, pain management, spinal injuries, and vocational assessments for individuals with ongoing impairments. He holds multiple accreditations in the field, including certifications in the American Medical Association's Guides to the Evaluation of Permanent Impairment (4th, 5th, and 6th Editions), as well as being a WorkSafe accredited medical practitioner and impairment assessor.

Dr. Bala earned his Bachelor of Medicine, Bachelor of Surgery from the University of Madras, India, and has further distinguished himself through his Fellowship with the Royal Australian College of Physicians and other prestigious qualifications. His career spans senior roles in both public and private rehabilitation services in Australia, including positions at Wollongong, Port Kembla, and Masada Private Hospitals, as well as roles in pain management and brain injury rehabilitation at renowned institutions like Austin Health and Monash Health.

In addition to his clinical work, Dr. Bala is deeply involved in research, particularly in spinal injury services at Austin Health. He is an active member of several professional organizations, including the Royal Australasian College of Physicians, the European Stroke Council, and the International Society of Physical Medicine and Rehabilitation. His diverse experience and commitment to advancing the field make him a leading expert in rehabilitation medicine.