SYMPTOMS OF PARKINSON'S DISEASE Edited by Abdul Qayyum Rana Symptoms of Parkinson's Disease Edited by Abdul Qayyum Rana Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Silvia Vlase Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Laurin Rinder, 2011. Used under license from Shutterstock.com First published September, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] Symptoms of Parkinson's Disease, Edited by Abdul Qayyum Rana p. cm. 978-953-307-464-1 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Chapter 1 Cognitive Dysfunction in Parkinson’s Disease 1 Sara Varanese, Bernardo Perfetti and Alessandro Di Rocco Chapter 2 Cognition and Gait Disturbances in Parkinson's Disease 25 Samo Ribarič Chapter 3 Nocturnal Disturbances in Patients with Parkinson’s Disease 53 Keisuke Suzuki, Tomoyuki Miyamoto, Masayuki Miyamoto, Masaoki Iwanami and Koichi Hirata Chapter 4 Neuropsychological Deficits in Initial Parkinson’s Disease 69 Raquel Rodriguez Fernandez and Jose Antonio Muñiz Casado Chapter 5 Pathophysiology of Drug-Induced Dyskinesias 83 Christopher A. Lieu, Vikram Shivkumar, Timothy P. Gilmour, Kala Venkiteswaran, Mark J. Nolt, Milind Deogaonkar and Thyagarajan Subramanian Chapter 6 Preclinical Solutions for Insight in Premotor Parkinson 115 Ingrid H.C.H.M. Philippens and Peternella S. Verhave Chapter 7 Cognitive and Psychiatric Aspects of Parkinson’s Disease 143 Caspar Stephani Chapter 8 The Psychosocial Impact of Parkinson’s Disease on the Wider Family Unit: A Focus on the Offspring of Affected Individuals 165 David Morley VI Contents Chapter 9 The Negative Impact of Apathy in Parkinson’s Disease 179 Iracema Leroi Chapter 10 Gastrointestinal Dysfunction in Parkinson’s Disease 193 Klaus Krogh Preface Parkinson’s disease affects many different systems of human body and has both motor as well as non-motor symptoms. As the disease advances, both motor and non-motor symptoms progress and result in significant disability. Indeed with progression of time non-motor symptoms may become major cause of disease caregiver’s burden and morbidity. This book discusses in detail the various symptoms of Parkinson’s disease. Postural and gait problems have been discussed at length as they are the main cause of balance problems. Among the non-motor symptoms cognitive dysfunction which is one of the important causes of long term care placement has also been reviewed in detail. A review of gastrointestinal symptoms which affect almost 90% of patient population has been given as well. A focused discussion of mechanisms involving the psychiatric and mood disturbances which have a negative impact on the quality of life of patients has also been provided. In addition to these symptoms, a synopsis of other non-motor symptoms has also been given so that reader can have familiarity with the diversity of non-motor symptoms of Parkinson’s disease. The relevant information is not only detailed but at the same time focused and is readily available to the reader. Health care professionals and other individuals working in the field of science can benefit to a great extent from this book. Every effort has been made to present correct and up to date information in this book but medicine is a field with ongoing research and development, therefore readers may use other sources if the content of this book is found to be insufficient. Authors, editor, and publisher are not responsible for any errors, omissions, or consequences from the application of this information. Dr. Abdul Qayyum Rana Parkinson's Clinic of Eastern Toronto & Movement Disorders Center, Toronto, Canada