Sensory symptoms in Parkinson's disease: Clinical features, pathophysiology, and treatment

Zhu, Mingxin; Li, Man; Ye, Dawei; Jiang, Wei; Lei, Ting; Shu, Kai

doi:10.1002/jnr.23729

Cited by 27 publications

(15 citation statements)

References 116 publications

(168 reference statements)

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“…While Parkinson's disease is traditionally considered a movement disorder, it is accompanied by various cognitive, emotional and sensory symptoms. Among frequently occurring sensory symptoms in Parkinson's disease is pain that can be characterized either central neuropathic or nociceptive type of pain (Conte et al, 2013;Zhu et al, 2016). It is well established that impairment of the nigrostriatal dopaminergic system is a pathognomonic finding of the Parkinson's disease that can be demonstrated under in vivo conditions using PET (Niccolini et al, 2014).…”

Section: Central Pain In Parkinson's Diseasementioning

confidence: 99%

Dopaminergic and serotonergic mechanisms in the modulation of pain: In vivo studies in human brain

Martikainen

Hagelberg

Jääskeläinen

et al. 2018

European Journal of Pharmacology

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Here we review the literature assessing the roles of the brain dopaminergic and serotonergic systems in the modulation of pain as revealed by in vivo human studies using positron emission tomography. In healthy subjects, dopamine D/D receptor availability particularly in the striatum and serotonin 5-HT and 5-HT receptor availabilities in the cortex predict the subject's response to tonic experimental pain. High availability of dopamine D/D or serotonin 5-HT receptors is associated with high pain intensity, whereas high availability of 5-HT receptors associates with low pain intensity. Chronic neuropathic pain is associated with high striatal dopamine D/D receptor availability, for which low endogenous dopamine tone is a plausible explanation, although a compensatory increase in striatal dopamine D/D receptor density may also contribute. In contrast, chronic musculoskeletal pain is associated with low baseline availability of striatal dopamine D/D receptors. In healthy subjects, brain serotonin 5-HT as well as dopamine D/D receptor availabilities associate with the subject's response criterion rather than the capacity to discriminate painful thermal stimuli suggesting that these neurotransmitter systems act mainly on non-sensory rather than sensory factors of thermally induced pain experience. Additionally, 5-HT receptor availability predicts the subject's discriminative ability but not response criterion for non-painful tactile test stimuli, while no such correlation is observed with dopamine D/D receptors. These findings suggest that dopamine acting on striatal dopamine D/D receptors and serotonin acting on cortical 5-HT and 5-HT receptors contribute to top-down pain regulation in humans.

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Section: Central Pain In Parkinson's Diseasementioning

confidence: 99%

Dopaminergic and serotonergic mechanisms in the modulation of pain: In vivo studies in human brain

Martikainen

Hagelberg

Jääskeläinen

et al. 2018

European Journal of Pharmacology

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“…Jedynym wyjątkiem jest sy tuacja, w której pacjent jest kobietą z drżeniem jako do minującym objawem [38]. Zaburzenia węchowe uważane są za jeden z najwyraźniejszych i najwcześniejszych ob jawów prodromalnych PD, który wyprzedza pojawienie się objawów motorycznych o 4-7 lat [15,25,26,39,40] i jest biomarkerem w dwóch innych synukleinopatiach: incydentalnej chorobie ciałek Lewy' ego oraz zaburze niach zachowania podczas snu fazy REM [36]. Ok. 80% pacjentów cierpi na hipozmię, lecz nie anozmię -i nie jest świadomych utraty węchu lub ją zdecydowanie nie doszacowuje [25].…”

Section: Występowanie Zaburzeń Węchu W Chorobie Parkinsonaunclassified

“…The only exception is the situation where the patient is a wom an with tremor as the predominant symptom [38]. Ol factory dysfunction is considered to be one of the most evident and earliest prodromal symptoms of PD, which precedes the occurrence of motor symptoms by 47 years [15,25,26,39,40] and is a biomarker in two other synu cleinopathies: incidental Lewy body disease and REM sleep behaviour disorders [36]. Approximately 80% of patients suffer from hyposmia, but not from anosmia -and are not aware of the loss of smell or significantly underestimate it [25].…”

Section: Występowanie Zaburzeń Węchu W Chorobie Parkinsonamentioning

confidence: 99%

“…Hyposmia in PD is bilateral in nature and is independent of the severity and duration of the disease [39]. However, there is no correla tion between the severity of olfactory dysfunction and depression in PD [47].…”

Section: Olfactory Dysfunction and Other Clinical Aspects Of Parkinsomentioning

confidence: 99%

“…Hipozmia w przebiegu PD ma charakter bilateralny, a jej wielkość nie jest zależna od nasilenia i długości choroby [39]. Nie stwierdza się natomiast związku między głęboko ścią zaburzeń węchowych a depresją w przebiegu PD [47].…”

Section: Dysfunkcja Węchowa a Inne Aspekty Kliniczne Choroby Parkinsonaunclassified

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Olfactory dysfunctions occurring in the course of Parkinson’s disease

Śmigórski¹,

Śmigórska²

2017

ppn

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Purpose: The aim of this article is to provide a summary of findings concerning the olfactory loss associated with pathological neuro degenerative changes which occur in the course of Parkinson's disease. Views: Olfactory function deficits occur in the early, prodromal stage of Parkinson's disease and their severity is much higher, especially compared with other neurodegenerative diseases. Information on characteristics of olfactory loss in Parkinson's disease is presented in the article. Conclusions: Authors indicate that olfactory function assessment is useful in differential diagnosis of neurodegenerative disorders in their prodromal stage and physiological aging. Olfactory ability evaluation may be also very helpful in differential diagnosis of parkinsonism syndromes. Severity of the olfactory impairment may be a good predictor of neuropsychiatric complications de velopment in Parkinson's disease. Key words: Parkinson's disease, olfaction disorders, olfactory perception, dementia, smell. StreszczenieCel: Celem artykułu jest przedstawienie stanu wiedzy na temat utraty sprawności węchowej związanej z patologicznymi zmianami neurozwyrodnieniowymi zachodzącymi w przebiegu choroby Parkinsona. Poglądy: Zaburzenia sprawności węchowej pojawiają się we wczesnym, prodromalnym etapie rozwoju choroby Parkinsona, a ich natężenie jest większe niż w innych chorobach neurozwyrodnieniowych. W artykule przedstawiono informacje na temat charakte rystyki utraty węchu w chorobie Parkinsona.Wnioski: Autorzy wykazują, że ocena sprawności węchowej jest użyteczna w różnicowaniu zaburzeń neurozwyrodnieniowych w ich prodromalnym stadium z fizjologicznym starzeniem się. Ewaluacja sprawności węchowej może być również bardzo pomocna w róż nicowaniu diagnostycznym zespołów parkinsonowskich. Głębokość zaburzeń węchowych może być dobrym predyktorem rozwoju zaburzeń neuropsychiatrycznych w chorobie Parkinsona. Słowa kluczowe: choroba Parkinsona, zaburzenia węchu, percepcja węchowa, otępienie, węch.

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Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease

Schrag

Bohlken

Dammertz³

et al. 2023

JAMA Neurol

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ImportanceThe prodromal phase of Parkinson disease (PD) may last for more than 10 years. Recognition of the spectrum and occurrence of risk factors, comorbidities, and prodromal features of PD can increase understanding of the causes and development of the disease and help identify individuals at risk.ObjectiveTo identify the association of a subsequent diagnosis of PD with a range of risk factors and prodromal features, including lifestyle factors, comorbidities, and potential extracerebral manifestations of PD.Design, Setting, and ParticipantsThis was a case-control study using insurance claims of outpatient consultations of patients with German statutory health insurance between January 1, 2011, and December 31, 2020. Included were patients with incident diagnosis of PD without a previous diagnosis of parkinsonism or dementia and controls matched 1:2 for age, sex, region, and earliest year of outpatient encounter.ExposuresExposures were selected based on previous systematic reviews, case-control and cohort studies reporting on risk factors, comorbidities, and prodromal features of PD.Main Outcomes and MeasuresPreviously postulated risk factors and prodromal features of PD, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding.ResultsA total of 138 345 patients with incident PD (mean [SD] age, 75.1 [9.8] years; 73 720 male [53.3%]) and 276 690 matched controls (mean [SD] age, 75.1 (9.8) years; 147 440 male [53.3%]) were identified. Study participants were followed up for a mean (SD) of 6.0 (2.0) years. Consistent with previous reports, risk factors and prodromal features associated with PD included traumatic brain injury, odds ratio (OR), 1.62; 95% CI, 1.36-1.92; alcohol misuse, OR, 1.32; 95% CI, 1.21-1.44; hypertension, OR, 1.29; 95% CI, 1.26-1.31; anosmia, OR, 2.16; 95% CI, 1.59-2.93; and parasomnias (including RBD), OR, 1.62; 95% CI, 1.42-1.84. In addition, there were associations with restless legs syndrome (OR, 4.19; 95% CI, 3.91-4.50), sleep apnea (OR, 1.45; 95% CI, 1.37-1.54), epilepsy (OR, 2.26; 95% CI, 2.07-2.46), migraine (OR, 1.21; 95% CI, 1.12-1.29), bipolar disorder (OR, 3.81; 95% CI, 3.11-4.67), and schizophrenia (OR, 4.48; 95% CI, 3.82-5.25). The following diagnoses were also found to be associated with PD: sensory impairments beyond anosmia, such as hearing loss (OR, 1.14; 95% CI, 1.09-1.20) and changes of skin sensation (OR, 1.31; 95% CI, 1.21-1.43). There were also positive associations with skin disorders (eg, seborrheic dermatitis, OR, 1.30; 95% CI, 1.15-1.46; psoriasis, OR, 1.13; 95% CI, 1.05-1.21), gastrointestinal disorders (eg, gastroesophageal reflux, OR, 1.29; 95% CI, 1.25-1.33; gastritis, OR, 1.28; 95% CI, 1.24-1.33), conditions with a potential inflammatory component (eg, seronegative osteoarthritis, OR, 1.21; 95% CI, 1.03-1.43), and diabetes types 1 (OR, 1.32; 95% CI, 1.21-1.43) and 2 (OR, 1.24; 95% CI, 1.20-1.27). Associations even 5 to 10 years before diagnosis included tremor (odds ratio [OR], 4.49; 95% CI, 3.98-5.06), restless legs syndrome (OR, 3.73; 95% CI, 3.39-4.09), bipolar disorder (OR, 3.80; 95% CI, 2.82-5.14), and schizophrenia (OR, 4.00; 95% CI, 3.31-4.85).Conclusions and RelevanceResults of this case-control study suggest that the associations found between PD and certain risk factors, comorbidities, and prodromal symptoms in a representative population may reflect possible early extrastriatal and extracerebral pathology of PD. This may be due to shared genetic risk with PD, medication exposure, or direct causation, or represent pathophysiologically relevant factors contributing to the pathogenesis of PD.

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Sensory symptoms in Parkinson's disease: Clinical features, pathophysiology, and treatment

Cited by 27 publications

References 116 publications

Dopaminergic and serotonergic mechanisms in the modulation of pain: In vivo studies in human brain

Dopaminergic and serotonergic mechanisms in the modulation of pain: In vivo studies in human brain

Olfactory dysfunctions occurring in the course of Parkinson’s disease

Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease

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