1
|
Nogueira ACR, Pereira KC, Rodrigues VF, Alves DDPA, Marques JB, Monteiro ER, Jesus IRTD. Pain characterization in patients with Parkinson's disease. Pain Pract 2024; 24:786-797. [PMID: 38294086 DOI: 10.1111/papr.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Patients with Parkinson's disease (PD) often report chronic pain, which is one of the most complex non-motor symptoms. Therefore, this study aims to review the literature on the characteristics of pain in patients with PD. METHODS A systematic literature review was conducted following MOOSE recommendations. Observational studies reporting pain in patients with PD were included. No time restrictions were applied, but studies in Portuguese, Spanish, and English were considered. The search was performed in PubMed®, LILACS, and SciELO databases. RESULTS Twenty-six articles of observational studies were identified, reporting an average pain prevalence of 67.36%, emphasizing the significance of this symptom in the PD population. Pain was reported in various body regions, including lower limbs, upper limbs, lumbar spine, cervical spine, and other joints. Pain classification varied, encompassing musculoskeletal pain, PD-related pain, neuropathic pain, and dystonic pain, among others. DISCUSSION Pain in patients with PD is a prevalent and multifactorial condition, significantly impacting patients' quality of life. CONCLUSION Heterogeneity in data across included studies was observed, highlighting the need for additional research to elucidate the underlying mechanisms of pain in patients with PD and develop effective therapeutic strategies to address this symptom and improve the quality of life for individuals living with the disease.
Collapse
Affiliation(s)
| | | | | | | | | | - Estêvão Rios Monteiro
- Centro Universitário Augusto Motta, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- IBMR University Center, Rio de Janeiro, Brazil
| | | |
Collapse
|
2
|
Qamar MA, Tall P, van Wamelen D, Wan YM, Rukavina K, Fieldwalker A, Matthew D, Leta V, Bannister K, Chaudhuri KR. Setting the clinical context to non-motor symptoms reflected by Park-pain, Park-sleep, and Park-autonomic subtypes of Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 174:1-58. [PMID: 38341227 DOI: 10.1016/bs.irn.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Non-motor symptoms (NMS) of Parkinson's disease (PD) are well described in both clinical practice and the literature, enabling their management and enhancing our understanding of PD. NMS can dominate the clinical pictures and NMS subtypes have recently been proposed, initially based on clinical observations, and later confirmed in data driven analyses of large datasets and in biomarker-based studies. In this chapter, we provide an update on what is known about three common subtypes of NMS in PD. The pain (Park-pain), sleep dysfunction (Park-sleep), and autonomic dysfunction (Park-autonomic), providing an overview of their individual classification, clinical manifestation, pathophysiology, diagnosis, and potential treatments.
Collapse
Affiliation(s)
- Mubasher A Qamar
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom.
| | - Phoebe Tall
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Daniel van Wamelen
- Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Yi Min Wan
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Psychiatry, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Katarina Rukavina
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Anna Fieldwalker
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Central Modulation of Pain Lab, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Donna Matthew
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Valentina Leta
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Clinical Neurosciences, Parkinson, and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Kirsty Bannister
- Central Modulation of Pain Lab, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| |
Collapse
|
3
|
Zhang Y, Xu X. Chinese Herbal Medicine in the Treatment of Depression in Parkinson’s Disease: From Molecules to Systems. Front Pharmacol 2022; 13:879459. [PMID: 35496318 PMCID: PMC9043316 DOI: 10.3389/fphar.2022.879459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Depression is one of the most common non-motor symptoms in patients with Parkinson’s disease (PD). Depression in PD (DPD) increases the disability rate and reduces the quality of life of PD patients and increases the caregiver burden. Although previous studies have explained the relationship between depression and PD through a variety of pathological mechanisms, whether depression is a precursor or an independent risk factor for PD remains unclear. Additionally, increasing evidence shows that conventional anti-PD drug therapy is not ideal for DPD. Chinese Herbal Medicine (CHM) prescriptions exhibit the characteristics of multi-target, multi-pathway, and multi-level treatment of DPD and may simultaneously improve the motor symptoms of PD patients through multiple mechanisms. However, the specific pharmacological mechanisms of these CHM prescriptions remain unelucidated. Here, we investigated the mechanisms of action of the active ingredients of single herbs predominantly used in CHM prescriptions for depression as well as the therapeutic effect of CHM prescriptions on DPD. This review may facilitate the design of new selective and effective treatment strategies for DPD.
Collapse
Affiliation(s)
- Yi Zhang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoman Xu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiaoman Xu,
| |
Collapse
|
4
|
Gültekin H, BAYRAM DERYA, Yüksel GA, Bayram T, Tireli H. Assessment Of Modified-Modified Schober Test And Lomber Range Of Motion In Parkinson’s Patients With And Without Low Back Pain. TURKISH JOURNAL OF NEUROLOGY 2022. [DOI: 10.4274/tnd.2022.74050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
5
|
Wu P, Du B, Wang B, Yin R, Lv X, Dai Y, Zhang W, Xia K. Joint Analysis of Genome-Wide Association Data Reveals No Genetic Correlations Between Low Back Pain and Neurodegenerative Diseases. Front Genet 2021; 12:744299. [PMID: 34630533 PMCID: PMC8493037 DOI: 10.3389/fgene.2021.744299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/23/2021] [Indexed: 12/25/2022] Open
Abstract
Background: We aimed to explore the genetic correlation and bidirectional causal relationships between low back pain (LBP) and three neurodegenerative diseases, Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS). Methods: Summary-level statistics were obtained from genome-wide association studies of LBP (n = 177,860), AD (n = 63,926), PD (n = 482,730), and ALS (n = 80,610). We implemented linkage disequilibrium score regression to calculate heritability estimates and genetic correlations. To investigate possible causal associations between LBP and three neurodegenerative diseases, we also conducted a bidirectional two-sample Mendelian randomization (MR) study. Inverse variance-weighted MR was employed as the primary method to generate overall estimates, whereas complementary approaches and sensitivity analyses were conducted to confirm the consistency and robustness of the findings. Results: There was no evidence of genetic correlations between LBP and AD (Rg = −0.033, p = 0.766). MR analyses did not support the causal effect of LBP on AD (OR = 1.031; 95% CI, 0.924–1.150; p = 0.590) or the effect of AD on LBP (OR = 0.963; 95% CI, 0.923–1.006; p = 0.090). Likewise, this study failed to identify genetic correlations between LBP and two other neurodegenerative diseases. MR results of the associations of LBP with PD and ALS, and the reverse associations, did not reach Bonferroni-corrected significance. Conclusion: The study did not support genetic correlations or causations between LBP and three common neurodegenerative diseases, AD, PD, and ALS in the European population.
Collapse
Affiliation(s)
- Pengfei Wu
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China.,Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Bing Du
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.,Center for Digital Spine Surgery, Central South University, Changsha, China
| | - Rui Yin
- Department of Biomedical Informatics and Harvard Medical School, Boston, MA, United States
| | - Xin Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuliang Dai
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.,Center for Digital Spine Surgery, Central South University, Changsha, China
| | - Wan Zhang
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.,Department of Biology, College of Arts & Sciences, Boston University, Boston, MA, United States
| | - Kun Xia
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Shanghai, China.,Hengyang Medical School, University of South China, Hengyang, China
| |
Collapse
|
6
|
Tueth LE, Duncan RP. Musculoskeletal pain in Parkinson's disease: a narrative review. Neurodegener Dis Manag 2021; 11:373-385. [PMID: 34410146 PMCID: PMC8515213 DOI: 10.2217/nmt-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
The prevalence of musculoskeletal (MSK) pain in people with Parkinson's disease (PD) is higher than that of age-matched controls. In this review, we outline what is known about MSK pain in PD, focusing on the neck, shoulder, knee, hip and low back. We also compare what is known about MSK pain in PD to what is known in older adults without PD. Finally, we outline areas of for future research related to MSK pain in people with PD.
Collapse
Affiliation(s)
- Lauren Elizabeth Tueth
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
| | - Ryan P Duncan
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
- Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
| |
Collapse
|
7
|
|
8
|
Silveira Barezani AL, de Figueiredo Feital AMB, Gonçalves BM, Christo PP, Scalzo PL. Low back pain in Parkinson's disease: A cross-sectional study of its prevalence, and implications on functional capacity and quality of life. Clin Neurol Neurosurg 2020; 194:105787. [PMID: 32244035 DOI: 10.1016/j.clineuro.2020.105787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 02/04/2020] [Accepted: 03/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the prevalence of low back pain (LBP) in patients with Parkinson's disease (PD) and its impact on functional capacity and quality of life. METHODS Patients with idiopathic PD answered a questionnaire and were submitted to a clinical and functional assessment. Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale, Beck Depression Inventory (BDI), McGill Pain Questionnaire (McGill), Roland Morris Disability Questionnaire (RMDQ), 39-item Parkinson's Disease Questionnaire (PDQ-39) were used. In addition, the ability to contract transversus abdominis (TrA) was assessed. RESULTS One hundred and fifteen patients answered the questionnaire, and 95 (82.6 %) reported painful symptoms. Of these, 67 (58.3 %) had chronic LBP, and approximately 40 % patients reported its onset before diagnosis of PD. Higher scores in pain intensity, depressive symptoms and UPDRS II and III, more advanced stages of PD, and absence of TrA contraction determined poor functional limitation induced by LBP. However, pain intensity (McGill), severity of PD symptoms (UPDRS III) and absence of TrA contraction were identified as predictive factors for functional limitation and explained 66.1 % of the variance in the RMDQ. Pain intensity and LBP-related disability caused negative impact on the quality of life. CONCLUSION LBP is common in patients with PD and it causes disability and poor quality of life. Pain intensity, UPDRS III and absence of TrA contraction were the most significant predictive factors for disability assessed by the RMDQ.
Collapse
Affiliation(s)
| | | | - Bernardo Machado Gonçalves
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Paulo Pereira Christo
- Centro de Especialidades Médicas da Santa Casa de Belo Horizonte, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
| | - Paula Luciana Scalzo
- Department of Morphology, Institute of Biological Sciences and Program in Neuroscience, Universidade Federal de Minas Gerais, Belo Horizonte, Mina Gerais, Brazil.
| |
Collapse
|
9
|
Tai YC, Lin CH. An overview of pain in Parkinson's disease. Clin Park Relat Disord 2019; 2:1-8. [PMID: 34316612 PMCID: PMC8302194 DOI: 10.1016/j.prdoa.2019.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/20/2019] [Accepted: 11/25/2019] [Indexed: 12/13/2022] Open
Abstract
Pain is a common non-motor symptom of Parkinson's disease (PD) and the prevalence of pain among PD patients varies because of the disease stage, co-morbidities, and evaluating tools. Risk factors for pain in PD include an early age of onset, long disease duration, motor complications, concomitant depressive symptoms, female gender, and associated medical conditions. In patients with PD, pain can be classified as musculoskeletal pain, chronic body pain (central or visceral), fluctuation-related pain, nocturnal pain, orofacial pain, pain with discolouration/oedema/swelling, and radicular/neuropathic pain; musculoskeletal pain as the most common type. Potential underlying mechanisms include a disruption of peripheral nociception and alterations in central pain threshold/processing. Genetic polymorphisms in genes that confer pain susceptibility might also play a role in the occurrence of pain in PD. In advanced stage of patients with PD, polyneuropathy could occur in patients using high dosage of levodopa. Pain often correlates to other non-motor symptoms of PD, including depression, sleep, and autonomic symptoms. Dopaminergic drugs, non-dopaminergic medications, botulinum toxin, deep brain stimulation, and physiotherapy have shown some benefits for certain types of PD-related pain. An increased awareness of pain as a common non-motor symptom of PD provides further insights into sensory system dysregulation in this disease. In this review, we aim to summarizes the clinical features of pain in patients with PD and emphasize the latest evidence of pain related to levodopa treatment.
Collapse
Affiliation(s)
- Yi-Cheng Tai
- Department of Neurology, E-DA Hospital, Kaohsiung, Taiwan
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University, College of Medicine, Taipei, Taiwan
| |
Collapse
|
10
|
Jost WH, Buhmann C. The challenge of pain in the pharmacological management of Parkinson's disease. Expert Opin Pharmacother 2019; 20:1847-1854. [PMID: 31290336 DOI: 10.1080/14656566.2019.1639672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Introduction: Pain is a common symptom in Parkinson's disease (PD), impairing quality of life. The clinical appearance and the underlying etiologies are diverse. Different subtypes of pain may occur, with musculoskeletal pain considered to be the most frequent. Often there is also a combination of different causes of pain. There is a lack of controlled studies addressing pain therapy in PD. Areas covered: In this review the authors analyzed the currently available data, taking into account the available publications in the databases, especially PubMed. The authors further provided their expert perspectives on the challenges of treating pain in PD patients. Expert opinion: There is both nociceptive and neuropathic pain and in patients with PD, some PD-related pain and some unrelated. Diagnosis requires a thorough and differentiated history and examination, and targeted diagnostics. Therapeutically, many drugs are used, but the data is unfortunately limited and not specific. Medications used include Parkinson-related, mainly dopaminergic drugs, as well as opioids and non-opioid analgetics, anticonvulsives, antidepressants, and more recently cannabinoids. Currently, therapy is performed nonspecifically, without taking into account the special requirements of PD. Unfortunately, in many cases, pain is resistant to these therapies. In the future, both diagnostic and therapeutic efforts should be made to address this issue.
Collapse
Affiliation(s)
| | - Carsten Buhmann
- Department of Neurology, Center for Clinical Neurosciences, University Medical Center , Hamburg , Germany
| |
Collapse
|
11
|
Mattos DC, Meziat Filho NA, Pedron CA, Vasconcellos LF, Nogueira LAC, Oliveira LAS. Pain Characteristics and Their Relationship With Motor Dysfunction in Individuals With Parkinson Disease—A Cross‐Sectional Study. Pain Pract 2019; 19:732-739. [DOI: 10.1111/papr.12803] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Danielle C. Mattos
- Post-Graduation Program in Rehabilitation Sciences Augusto Motta University Center (UNISUAM) Rio de Janeiro Brazil
| | - Ney A. Meziat Filho
- Post-Graduation Program in Rehabilitation Sciences Augusto Motta University Center (UNISUAM) Rio de Janeiro Brazil
| | - Carla A. Pedron
- Post-Graduation Program in Rehabilitation Sciences Augusto Motta University Center (UNISUAM) Rio de Janeiro Brazil
| | - Luiz F. Vasconcellos
- Institute of Neurology Deolindo Couto, Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro Brazil
| | - Leandro A. C. Nogueira
- Post-Graduation Program in Rehabilitation Sciences Augusto Motta University Center (UNISUAM) Rio de Janeiro Brazil
- School of Physiotherapy Federal Institute of Rio de Janeiro Rio de Janeiro Brazil
| | - Laura Alice Santos Oliveira
- Post-Graduation Program in Rehabilitation Sciences Augusto Motta University Center (UNISUAM) Rio de Janeiro Brazil
- School of Physiotherapy Federal Institute of Rio de Janeiro Rio de Janeiro Brazil
| |
Collapse
|