Environmental and Behavioral Interventions May Alleviate Nonmotor Symptoms of Parkinson’s Disease

Some studies show emotion recognition deficits in people with Parksinon’s disease. Buxton et al found that people with Parkinson’s disease were significantly different in their ability to detect subtle expressions of facial emotion and emotions conveyed by voices, compared with control participants. As an intervention, caregivers might try amplifying their expressions to help patients pick up emotional cues, said Dr. Cronin-Golomb.

Interventions for Sleep
Exercise interventions may improve sleep, although few studies of exercise interventions use sleep as an outcome measure. Nascimento et al showed a trend for improved sleep among patients who completed aerobic and conditioning exercise. Patients also had improved subjective quality of life.

CBT for insomnia is an effective treatment for primary insomnia and for insomnia related to many other conditions, but it probably is not an appropriate intervention for people with Parkinson’s disease because of its sleep restriction component. “For somebody at risk for falls, this is probably not something you want to be doing,” said Dr. Cronin-Golomb. Some evidence suggests that bright-light therapy might improve sleep, mood, and motor function, and that melatonin may improve subjective sleep quality, Dr. Cronin-Golomb said.

—Jake Remaly