Objective: We wanted to systematically analyse the repertoire of NMS in patients with progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD) and dementia with Lewy bodies (DLB).

Background: While the burden of non-motor symptoms in Parkinson’s disease is well recognised, the prevalence of non-motor symptoms (NMS) in atypical parkinsonian syndromes has not been studied in detail.

Method: We conducted a systematic review of case series involving PSP, MSA, CBD and DLB published in the English language in PUBMED and EMBASE databases from 1945 and 2020.

Results: Among 300 papers assessed, 26 case series involving 409 PSP cases, 543 MSA cases, 20 CBD and 48 DLB cases were included. The mean age for PSP was 68.5±2.8 years, MSA was 6.18±3.3, CBD was 65.0±6.4 and DLB was 75.8±2.4 Mean disease duration was similar for PSP 3.8±2.1 years, MSA 3.9±2.0, CBD 4.1±2.3 and DLB 4.1±0.2 (p=0.997). 55% were male. We found sleep disturbances to be more prevalent in PSP (75%), MSA (66.6%), and DLB (75%) compared to PD (37.2%) (p <0.001). Urinary symptoms were more prevalent in MSA (93.5%) and PD (79.9%) compared to PSP (49.3%), DLB (42%) and CBD (53.8%) (p<0.001). Orthostatic hypotension symptoms were more frequent in MSA (50.3%) (p<0.001) and PSP (28.4%) (p=0.003) compared to PD (14.7%) and DLB (24%) (p=0.168). Prevalence of depression was highest in MSA (86.3%), which was significantly higher than PSP (55.7%), DLB (44 %), CBD (47.6%), PD (36.6%) and healthy controls 14.9% (p<0.001).

Conclusion: Non-motor symptoms are common in atypical parkinsonian syndromes and, in most cases, are more prevalent in atypical parkinsonism than in PD. Unless systematically sought out in clinics, non-motor symptoms may typically be underreported by patients and remain largely unaddressed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-systematic-review-of-non-motor-symptoms-in-atypical-parkinsonian-syndromes/