Quantitative measurement of pain sensation in patients with Parkinson disease

Djaldetti, Ruth; Shifrin, Alla; Rogowski, Zeev; Sprecher, Elliot; Melamed, Eldad; Yarnitsky, David

doi:10.1212/01.wnl.0000130455.38550.9d

Cited by 265 publications

(223 citation statements)

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“…It provides information on the level and underlying mechanism of pain of various etiologies. Studies of QST in patients with PD and primary central pain reported impaired pain processing, with lower heat pain thresholds than in patients with PD without pain (Djaldetti et al, 2004;Schestatsky et al, 2007). Heat pain thresholds were also lower in the more affected than the less affected hand (Djaldetti et al, 2004).…”

Section: Introductionmentioning

confidence: 95%

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Shohet

Khlebtovsky

Roizen

et al. 2016

European Journal of Pain

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Background: Cannabis can alleviate pain of various etiologies. This study assessed the effect of cannabis on motor symptoms and pain parameters in patients with Parkinson's disease (PD). Methods: Twenty patients with PD who were licensed to use cannabis underwent evaluation before and 30 min after cannabis consumption and again after long-term use. Motor function was assessed with the Unified PD Rating scale (UPDRS) by two raters, one blinded. Pain was assessed with the Pain Rating Index (PRI) and Visual Analogue Scale (VAS) of the short-form McGill Pain Questionnaire. Thermal quantitative sensory testing (QST) was performed in 18 patients. The two consecutive QST measurements were validated in 12 cannabis-na€ ıve patients with PD. Results: There was a significant decrease from baseline to 30 min after cannabis consumption in mean motor UPDRS score (38.1 AE 18 to 30.4 AE 15.6, p < 0.0001), total PRI (27 AE 13.5 to 9.7 AE 11, p = 0.001), and VAS score (6.4 AE 2.8 to 3.6 AE 3.1, p = 0.0005). Mean cold pain threshold decreased significantly in the more affected limb, but only after exclusion of two patients who consumed cannabis by vaporizer rather than smoking (19.5 AE 5.2 to 15.6 AE 8.7°C, p = 0.02). After longterm (median 14 weeks) exposure, mean heat pain threshold decreased significantly in the more affected limb in all treated patients (43.6 AE 3.5 to 40.9 AE 3.3°C, p = 0.05) and in cannabis smokers (43.7 AE 3.6 to 40.3 AE 2.5°C, p = 0.008). Conclusions: Cannabis improved motor scores and pain symptoms in PD patients, together with a dissociate effect on heat and cold pain thresholds. Peripheral and central pathways are probably modulated by cannabis. Significance: Quantitative sensory test results are significantly altered following cannabis consumption in patients with PD. Cannabis probably acts on pain in PD via peripheral and central pathways.

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Section: Introductionmentioning

confidence: 95%

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Shohet

Khlebtovsky

Roizen

et al. 2016

European Journal of Pain

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“…Sensory symptoms (olfactory dysfunction, pain, paresthesia, akathisia, oral pain and genital pain) are frequent in PwP, but are often not recognised as parkinsonian symptoms [21,46,25,10].…”

Section: Motor Symptomsmentioning

confidence: 99%

User interface design guidelines for smartphone applications for people with Parkinson’s disease

Nunes

Silva

Cevada

et al. 2015

Univ Access Inf Soc

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Parkinson's disease (PD) is often responsible for difficulties in interacting with smartphones; however, research has not yet addressed these issues and how these challenge people with Parkinson's (PwP). This paper specifically investigates the symptoms and characteristics of PD that may influence the interaction with smartphones to then contribute in this direction. The research was based on a literature review of PD symptoms, eight semi-structured interviews with healthcare professionals and observations of PwP, and usability experiments with 39 PwP. Contributions include a list of PD symptoms that may influence the interaction with smartphones, a set of experimental results that evaluated the performance of four gestures tap, swipe, multiple-tap, and drag and 12 user interface design guidelines for creating smartphone user interfaces for PwP. Findings contribute to the work of re-

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“…The improvement of the pain was found in 59.26% of the patients under levodopa effect. However, in 40.7% of these patients this was not observed, suggesting that in addition to the patients who were in "wearing-off" status, there must have been nondopaminergic mechanisms related to primary pain in PD 14 . Recent studies had shown a reduction of the threshold to pain in PD 14,28 .…”

Section: Methodsmentioning

confidence: 88%

“…However, in 40.7% of these patients this was not observed, suggesting that in addition to the patients who were in "wearing-off" status, there must have been nondopaminergic mechanisms related to primary pain in PD 14 . Recent studies had shown a reduction of the threshold to pain in PD 14,28 . Brefel-Courbon et al 28 investigated the pain in PD patients and controls by means of thermal stimulation and cerebral activity with positron emission tomography.…”

Section: Methodsmentioning

confidence: 88%

“…Dystonia preferably occurs in the off period and generally on feet 13 . Primary parkinsonian pain is complex and may involve sensory pathways within the basal ganglia and the thalamocortical basal ganglia circuits 14 . lesions in dorsal horn layer I, parasympathetic and sympathetic pre and postganglionic neurons were described in PD patients that were positive for α -synuclein 15 .…”

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Pain in Parkinson's disease

Letro

Quagliato

Viana

2009

Arq. Neuro-Psiquiatr.

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-Pain may precede the diagnosis in Parkinson's disease (PD). The goal of this study was to assess the pain in a group of 20 females and 30 males with PD, after excluding co-morbidities as causes. It was used the following tools: Unified Parkinson's Disease Rating Scale, McGill questionnaire and Beck Depression Inventory. In 27 patients (54%), the pain was associated with PD, occurring in 22 (44%) in the off period and 5 (10%) in both on and off periods. The off period resulted in an increased frequency of pain, which was related to stiffness. There was no association between pain and tremor in off period, neither between pain and Modified Hoehn and Yahr stage, nor the Schwab and England scale. It was not observed an association between pain and depression, neither between pain and dyskinesia. It was noticed the improvement in pain in 16 patients with levodopa (59.26%). Em 27 pacientes (54%), a dor associou-se com a DP, ocorrendo em 22 (44%) no período off e em 5 (10%) nos períodos on e off. o período off resultou num aumento da freqüência da dor, o qual se relacionou com a rigidez. Não houve associação entre dor e tremor no período off, estágio Hoehn e Yahr modificado, nem a escala de Schwab e England. Não foi observado associação entre dor e depressão, nem entre dor e discinesia. Foi observada a melhora da dor em 16 pacientes com levodopa (59.26%).PAlAvRAS-CHAvE: doença de Parkinson, dor, levodopa.

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Quantitative measurement of pain sensation in patients with Parkinson disease

Abstract: Endogenous pain in patients with Parkinson disease is accompanied by increased sensitivity to some painful stimuli, suggesting that basal ganglia abnormality also involves pain encoding.

Cited by 265 publications

References 46 publications

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

User interface design guidelines for smartphone applications for people with Parkinson’s disease

Pain in Parkinson's disease

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