Gastrointestinal (GI) dysfunction is a common non-motor feature of Parkinson disease (PD). GI symptoms may start years before the onset of motor symptoms and impair quality of life. Robust clinical trial data is lacking to guide screening, diagnosis and treatment of GI dysfunction in PD. To develop consensus statements on screening, diagnosis, and treatment of GI dysfunction in PD. The application of a modified Delphi panel allowed for the synthesis of expert opinions into clinical statements. Consensus was predefined as a level of agreement of 100 % for each item. Five virtual Delphi rounds were held. Two movement disorders neurologists reviewed the literature on GI dysfunction in PD and developed draft statements based on the literature review. Draft statements were distributed among the panel that included five movement disorder neurologists and two gastroenterologists, both experts in GI dysmotility and its impact on PD symptoms. All members reviewed the statements and references in advance of the virtual meetings. In the virtual meetings, each statement was discussed, edited, and a vote was conducted. If there was not 100 % consensus, further discussions and modifications ensued until there was consensus. Statements were developed for screening, diagnosis, and treatment of common GI symptoms in PD and were organized by anatomic segments: oral cavity and esophagus, stomach, small intestine, and colon and anorectum. These consensus recommendations offer a practical framework for the diagnosis and treatment of GI dysfunction in PD.

Deep brain Stimulation (DBS) surgery effectively alleviates troublesome motor symptoms of Parkinson’s disease (PD) such as tremor, rigidity, bradykinesia, motor fluctuations and dyskinesia. It also improves some non-motor symptoms and quality of life. DBS should thus be considered when these symptoms interfere with quality of life despite optimal medical treatment. While DBS benefits are clear, access by eligible patients remains low. Patients and their caregivers should be educated regarding DBS surgery and referrals for surgical evaluation should occur alongside ongoing medication adjustments—particularly when those changes fail to adequately control motor symptoms—regardless of the stage of disease progression. This international panel of DBS experts developed consensus recommendations with the goals of promoting timely referrals and approvals, while reducing misconceptions and stigma associated with brain surgery. These recommendations provide a framework for referring providers, ensuring that appropriate candidates receive timely access to this beneficial treatment.

Thermoregulatory dysfunction—temperature intolerance and/or inappropriate compensation—is an underrecognized feature of Parkinson’s disease (PD) and is linked to poor quality of life. Multiple mechanisms may underlie this dysfunction, including α-synuclein deposition in relevant structures, altered functional connectivity in thermoregulatory networks, and disrupted neurotransmitter modulation, on top of the deleterious consequences of aging. Although multiple advanced tests can confirm this dysfunction, diagnosis is largely based on a detailed history. Once this critical symptom is identified, management focuses on crisis prevention and safety, as PD-specific clinical trials are often lacking. This narrative review of the literature addresses mechanisms, clinical expression, diagnostic evaluation, and management of thermoregulatory dysfunction in PD to help guide care for this underappreciated, yet potentially debilitating, non-motor symptom of PD. Future PD-specific trials are needed to further clarify underlying mechanisms and improve treatment options.