Pain as a Nonmotor Symptom of Parkinson Disease

Defazio, Giovanni; Berardelli, Alfredo; Fabbrini, Giovanni; Martino, Davide; Fincati, E.; Fiaschi, Antonio; Moretto, Giuseppe; Abbruzzese, Giovanni; Marchese, Roberta; Bonuccelli, Ubaldo; Dotto, Paolo Del; Barone, Paolo; Vivo, Elisa Delia De; Albanese, Alberto; Antonini, Angelo; Canesi, Margherita; Lopiano, Leonardo; Zibetti, Maurizio; Nappi, Giuseppe; Martignoni, E.; Lamberti, Paolo; Tinazzi, Michèle

doi:10.1001/archneurol.2008.2

Cited by 224 publications

(180 citation statements)

References 12 publications

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“…Our findings are similar to previous studies [1,3]. However, the frequency of dystonic pain in our study was lower than that previously reported [1,3,25]. Variation in the prevalence of the pain subtype may be related to the definition of pain, inclusion criteria, or differences in the patient population among the centers.…”

Section: Discussionsupporting

confidence: 86%

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The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease

Choi

Kim²,

Jung³

et al. 2017

Eur Neurol

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Background: Pain and osteoporosis are common in Parkinson's disease (PD), and lower bone mineral density (BMD) or osteoporosis may be associated with an increased risk of reporting to have pain in the general population. The aim of this study was to determine whether there is an association between the pain subtypes and the BMD in patients with PD. Methods: We included 162 PD patients. Pain was assessed using the patients' descriptions, a structured interview, a detailed neurologic examination, and the Visual Analogue Scale. BMD was measured using dual energy X-ray absorptiometry scans. Results: Of the 162 PD patients, 120 had chronic pain, while 42 reported no pain. The most prevalent type of pain was musculoskeletal, followed by radicular/neuropathic, dystonic, and central. PD patients with musculoskeletal pain had a lower BMD than PD patients without pain. Multivariate regression analysis showed that the low BMD of the lumbar spine, hip, and femoral neck were related to old age, female gender, low MBI, and the presence of musculoskeletal pain. Conclusion: PD patients with musculoskeletal pain have low BMD and are at risk for developing osteoporosis. If a PD patient has musculoskeletal pain and other risk factors related to low BMD, clinicians should consider screening for osteoporosis.

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Section: Discussionsupporting

confidence: 86%

“…In our study, the prevalence rate of chronic pain was 74.1%, which was within the range of previous reports (40-85%) [1,3,25,26]. The pathophysiology of pain in PD is multifactorial.…”

Section: Discussionsupporting

confidence: 86%

The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease

Choi

Kim²,

Jung³

et al. 2017

Eur Neurol

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“…9) One of the reasons is considered to be the decreased threshold of pain due to abnormality of the dopaminergic system in the basal ganglia of PD patients. 5,10) Administration of anti-parkinsonian medication 5,14) or DBS 16,20,23) results in increased pain thresholds.…”

Section: Introductionmentioning

confidence: 99%

Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Agari

Date

2012

Neurol. Med. Chir.(Tokyo)

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Patients with advanced Parkinson's disease (PD) often present with axial symptoms, including abnormal posture, postural instability, and gait disorder. Although spinal cord stimulation (SCS) is effective for pain, little is known about the effect of SCS on motor function in PD patients. The present study investigated the effect of SCS on posture and gait in 15 PD patients, 5 men and 10 women aged 63-79 years (mean 71.1 years), with low back pain and leg pain who received SCS. A visual analog scale (VAS) was used for pain evaluation pre-and postoperatively. The Unified Parkinson's Disease Rating Scale, Timed Up and Go tests, and Timed 10-Meter Walk tests were used to evaluate motor function and activities of daily living of patients. Preoperative mean VAS score was 8.9 (range 7.8-10), which showed significant postoperative improvement at 3 months to mean VAS score of 2.0 (range 0-3.3). The improvements in VAS scores persisted at 12 months after surgery with mean VAS score of 2.3 (range 0-4). Posture and postural stability motor subscores were improved at 3 months after SCS, and gait had significantly improved at 3 months and 1 year after surgery. Timed 10-Meter Walk tests also demonstrated that patient gait was significantly improved at 3 months and 12 months after surgery. Most advanced stage PD patients suffer considerable pain that causes abnormal posture and gait disturbance. SCS is expected to lead to both amelioration of pain and improvement of motor function in such patients.

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“…In advanced stages, pain may be caused by motor fluctuations (dyskinesia or off-period dystonia), and may be radicular or due to musculoskeletal problems [27,28]. In most of the published work, pain in PD was found to be related to a musculoskeletal cause or dystonia [1,3,29,30,31,32]. Musculoskeletal pain (44.4%) and dystonia-related pain (19.1%) were the most common types of pain (table 4).…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Chronic Pain in Parkinson's Disease Patients in Shanghai, China

Pan

Wang

et al. 2014

Integr Med Int

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Background/Aims: Pain in Parkinson's disease (PD) may be more distressing than that in other nonmotor disabilities. The aims of the present study were to assess the prevalence and identify the epidemiological characteristics of PD-related pain among patients with idiopathic PD in Shanghai, China. Methods: A total of 1,058 patients with definite idiopathic PD were investigated using a structure questionnaire in 12 hospitals in Shanghai. The severity of their motor disorders, antiparkinson treatments, and pain-related observations, such as time points for the onset of pain, duration and degree, body localization, external influences, and treatments for pain, were collected for analysis. Results: Approximately 28% (296 subjects) of all PD patients suffered from PD-related pain. Female patients with pain had a higher age level, were older at PD onset, had a higher frequency of pain, a higher frequency of pain before the onset of PD symptoms, a longer duration of pain, and a higher incidence of pain in the early stage compared to male patients. Larger levodopa-equivalent doses, higher frequencies of sleep disorders and/or motor fluctuation, and/or dyskinesia were found in patients with pain compared to patients without pain. The most frequent pain type was musculoskeletal pain followed by dystonia. The male group had a much shorter pain duration than the female group. The patients experienced more pain before taking antiparkinson drugs compared to after treatment. Conclusion: Chronic PD-related pain is a frequent complaint and complex in PD. The challenge of managing pain in PD patients will hopefully someday result in specific and effective treatment strategies. i 2014 S. Karger AG, Basel

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Pain as a Nonmotor Symptom of Parkinson Disease

Abstract: To determine whether pain is more frequent among people with Parkinson disease (PD) than among age-matched controls.

Cited by 224 publications

References 12 publications

The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease

The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease

Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Clinical Study on Chronic Pain in Parkinson's Disease Patients in Shanghai, China

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