Interventions for Motor and Non-Motor Symptoms in Parkinson’s Disease: An Umbrella Review with Meta-Analysis

Review

Interventions for Motor and Non-Motor Symptoms in Parkinson’s Disease: An Umbrella Review with Meta-Analysis

Rafaela Nonato de Menezes ^a ^*, Alane Medeiros Silva ^b, Davi Pedro Soares Macedo ^c, Uilna Natércia Soares Feitosa Pedro ^d, Edglê Pedro de Sousa Filho ^e, Danilo Ferreira de Sousa ^f

^a Nutritionist. Centro Universitário de Juazeiro do Norte – UNIJUAZEIRO.

^b Nursing. Universidade Federal do Ceará, Ceará, Brasil.

^c Medicine. Faculdade Paraíso Araripina.

^d Nursing. Universidade de Fortaleza, Fortaleza, Brasil.

^e Medicine. Universidade Federal do Ceará, Ceará, Brasil.

^f Nurse, PhD from Universidade Federal do Ceará.

ARTICLE INFO
Edited by Dr G Liu
Keywords:
Parkinson Disease
Meta-Analysis as Topic
Cognition Disorders / therapy
Quality of Life

Highlights

Interventions targeting Parkinson’s disease exert modest but meaningful effects across cognitive, psychological, and motor domains.

ABSTRACT

The objective of this study was to conduct an umbrella review with meta-analysis to evaluate the effectiveness of pharmacological, non-pharmacological, and combined interventions in Parkinson’s disease (PD), focusing on both motor and non-motor outcomes. Systematic reviews and meta-analyses published up to December 2024 were identified through PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and PsycINFO. Eligible outcomes included cognition, depression, sleep disturbances, fatigue, gait parameters, and quality of life. Methodological quality was appraised with AMSTAR 2, risk of bias with ROBIS, and certainty of evidence with GRADE. A random-effects model using the Restricted Maximum Likelihood (REML) method was applied, with heterogeneity assessed by Q, τ², and I² statistics.

A total of reviews encompassing multiple primary studies were included, covering diverse interventions and outcome measures. Results demonstrated modest improvements in global cognition, depressive symptoms, and quality of life, with small but clinically relevant gains in gait-related outcomes. Sleep and fatigue outcomes showed preliminary but encouraging findings. Heterogeneity was moderate (I² = 33.8%), and funnel plot asymmetry suggested potential publication bias. In conclusion, interventions in PD provide incremental yet meaningful benefits across motor and non-motor domains. Future large-scale, standardized, and multimodal trials are warranted to strengthen the evidence base and guide patient-centered care.

Article

Nevertheless, the findings underscore the clinical relevance of even incremental improvements, which can significantly impact autonomy, functional capacity, and overall well-being in individuals living with Parkinson’s disease.

The objective of this study was to conduct a meta-analysis of interventions in Parkinson’s disease, synthesizing evidence across motor and non-motor outcomes, including cognition, depression, sleep, fatigue, gait parameters, and quality of life.