Abstract
Although most of the symptoms of Parkinson’s disease (PD) seem to be motor-based, the non-motor symptoms (NMSs) of PD, often overshadowed, also constitute a major clinical challenge. The NMSs of PD, including neuropsychiatric, cognitive, gastrointestinal and sensory, not only are observed in later stages but also predominate in the early stages of PD. Research suggests that NMSs are present at onset, while some can precede the motor symptoms, often by many years [1–3]. The identification of premotor stages is based on the early detection of the combination of NMSs with PD detection: for example, olfactory changes are the most common NMS presenting in the early stages of PD and occur in 90 % of the patients [4, 5].
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