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Salabasidou E, Binder T, Volkmann J, Kuzkina A, Üçeyler N. Pain in Parkinson disease: a deep phenotyping study. Pain 2024; 165:1642-1654. [PMID: 38314763 DOI: 10.1097/j.pain.0000000000003173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 12/04/2023] [Indexed: 02/07/2024]
Abstract
ABSTRACT In our prospective cross-sectional study, we comprehensively characterized Parkinson disease (PD)-related pain in monocentrically recruited patients with PD using standardized tools of pain assessment and categorization. One hundred fifty patients were systematically interviewed and filled in questionnaires for pain, depression, motor, and nonmotor symptoms. Patients with PD-related pain (PD pain), patients without PD-related pain (no PD pain), and patients without pain (no pain) were compared. Pain was present in 108/150 (72%) patients with PD, and 90/150 (60%) patients were classified as having PD-related pain. Most of the patients with PD (67/90, 74%) reported nociceptive pain, which was episodic (64/90, 71%), primarily nocturnal (56/90, 62%), and manifested as cramps (32/90, 36%). Parkinson disease-related pain was most frequently located in the feet (51/90, 57%), mainly at the toe joints (22/51, 43%). 38/90 (42%) patients with PD-related pain received analgesic medication with nonsteroidal anti-inflammatory drugs being the most frequently used (31/42, 82%) and opioids most effective (70% pain reduction of individual maximum pain intensities, range 22%-100%, confidence interval 50%-90%). All patients received oral PD treatment; however, levodopa equivalent dose showed no correlation with mean pain intensities (Spearman ρ = 0.027, P > 0.05). Our data provide a comprehensive analysis of PD-related pain, giving evidence for mainly non-neuropathic podalgia, which bears the potential to rethink assessment and analgesic treatment of pain in PD in clinical practice.
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Affiliation(s)
- Elena Salabasidou
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany. Kuzkina is now with the Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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Nguy V, Brady B, Hassett LM, Canning CG, Elliott JM, Allen NE. A Mixed Methods Approach to Explore the Experience of Pain and Its Management in People with Parkinson's Disease. PARKINSON'S DISEASE 2024; 2024:8515400. [PMID: 38828214 PMCID: PMC11144069 DOI: 10.1155/2024/8515400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 06/05/2024]
Abstract
Introduction Pain in Parkinson's disease (PD) is common but poorly understood, with most research to date taking a mechanistic approach. This mixed methods study takes a broader biopsychosocial approach to assess and describe contributors of pain and explore pain management and the relationship between pain and physical activity in people with PD (PwPD) and chronic pain. Methods A structured survey evaluated respondents' contributors of pain using standardized, self-report assessments of the following: pain, peripheral neuropathy, central nociplastic change, emotional dysregulation or pathology, and maladaptive cognitions. Semistructured individual interviews were conducted with purposively sampled survey participants and analyzed using inductive thematic analysis. Results Eighty-nine PwPD (mean age 67 years, 55% female) completed the survey. The most common pain contributors were maladaptive cognitions (62%), central nociplastic change (49%), and emotional dysregulation (44%). Approaches to pain management and the response to physical activity were variable within and across individuals with different pain contributors. Four themes emerged from interviews with 24 participants: (1) causative perceptions of pain are diverse; (2) sense of control influences disease acceptance and exercise self-efficacy; (3) belief in the value of therapy; and (4) pain as the unspoken PD symptom. Physical activity was used by PwPD for pain management; however, the relationship between pain and physical activity varied based on sense of control. Conclusions Clinicians should screen for pain and assess its contributors to provide individualized, multidimensional pain management that considers the biological, psychological, and social factors of pain in PwPD. It is plausible that such an approach would promote a better sense of control for PwPD.
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Affiliation(s)
- Vanessa Nguy
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
| | - Bernadette Brady
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
- South West Sydney Local Health District, Sydney, Australia
| | - Leanne M. Hassett
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Camperdown, Australia
| | - Colleen G. Canning
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
| | - James M. Elliott
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
- The Kolling Institute, Northern Sydney (Arabanoo) Precinct, St Leonards, Australia
| | - Natalie E. Allen
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
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Allen NE, Romaliiska O, Naisby J. Pain and the Non-Pharmacological Management of Pain in People with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230227. [PMID: 38457146 DOI: 10.3233/jpd-230227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Pain is a distressing and universal experience, yet everyone's pain experience is influenced by a complex array of biological, psychological, and social factors. For people with Parkinson's disease (PwP), these biopsychosocial factors include neurodegeneration and the psychological and social factors that accompany living with a chronic, neurodegenerative condition in addition to the factors experienced by those in the general population (e.g., living with co-morbidities such as osteoarthritis). The way these factors influence each individual is likely to determine which pain management strategies are optimal for them. This review first describes pain and the biopsychosocial model of pain. It explores how pain is classified in Parkinson's disease (PD) and describes the three main types of pain: nociceptive, neuropathic, and nociplastic pain. This background provides context for a discussion of non-pharmacological pain management strategies that may aid in the management of pain in PwP; exercise, psychological strategies, acupuncture and massage. While there is little PD-specific research to inform the non-pharmacological management of pain, findings from current PD research are combined with that from chronic pain research to present recommendations for clinical practice. Recommendations include assessment that incorporates potential biopsychosocial contributors to pain that will then guide a holistic, multi-modal approach to management. As exercise provides overall benefits for PwP, those with chronic pain should be carefully monitored with exercise prescribed and adjusted accordingly. Research is needed to develop and evaluate multi-modal approaches to pain management that are delivered in a biopsychosocial framework.
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Affiliation(s)
- Natalie Elizabeth Allen
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Oksana Romaliiska
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
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Liu M, Gu H, Hu J, Liu M, Luo Y, Yuan Y, Wu J, Zhou Y, Juan R, Cheng X, Zhuang S, Shen Y, Jin H, Chen J, Li K, Wang F, Liu C, Mao C. Higher cortical excitability to negative emotions involved in musculoskeletal pain in Parkinson's disease. Neurophysiol Clin 2024; 54:102936. [PMID: 38382137 DOI: 10.1016/j.neucli.2023.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE Changes in brain structure and neurotransmitter systems are involved in pain in Parkinson's disease (PD), and emotional factors are closely related to pain. Our study applied electroencephalography (EEG) to investigate the role of emotion in PD patients with chronic musculoskeletal pain. METHODS Forty-two PD patients with chronic musculoskeletal pain and 38 without were enrolled. EEG data were recorded under resting conditions, and while viewing pictures with neutral, positive, and negative content. We compared spectrum power, functional connectivity, and late positive potential (LPP), an event-related potential (ERP), between the groups. RESULTS PD patients with pain tended to have higher scores for the Hamilton Rating Scale for Depression (HRSD). In the resting EEG, mean β-band amplitude was significantly higher in patients with pain than in those without. Logistic regression analysis showed that higher HRSD scores and higher mean β-band amplitude were associated with pain. ERP analysis revealed that the amplitudes of LPP difference waves (the absolute difference between positive and negative condition LPP and neutral condition LPP) at the central-parietal region were significantly reduced in patients with pain (P = 0.029). Spearman correlation analysis showed that the amplitudes of late (700-1000 ms) negative versus neutral condition LPP difference waves were negatively correlated with pain intensity, assessed by visual analogue scale, (r = -0.393, P = 0.010) and HRSD scores (r = -0.366, P = 0.017). CONCLUSION Dopaminergic and non-dopaminergic systems may be involved in musculoskeletal pain in PD by increasing β-band activity and weakening the connection of the θ-band at the central-parietal region. PD patients with musculoskeletal pain have higher cortical excitability to negative emotions. The changes in pain-related EEG may be used as electrophysiological markers and therapeutic targets in PD patients with chronic pain.
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Affiliation(s)
- Ming Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; The First People's Hospital of Zhangjiagang City, Suzhou, China
| | - Hanying Gu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jingzhe Hu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Manhua Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yajun Luo
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuan Yuan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiayu Wu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Zhou
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ru Juan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyu Cheng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Sheng Zhuang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Jin
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fen Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Chunfeng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Chengjie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Zimmers S, Robieux L, Bungener C. Towards a better Comprehension and Management of Pain and Psychological Distress in Parkinson's: The Role of Catastrophizing. J Geriatr Psychiatry Neurol 2023; 36:351-365. [PMID: 36740398 DOI: 10.1177/08919887231154932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Pain is very prevalent in Parkinson's and challenging to manage. As many people with Parkinson's (PwP) with pain suffer from anxious and depressive symptoms, we examined the role of catastrophizing in mediating the relationship between pain and psychological distress for this population. METHODS 169 international PwP completed an online survey with socio-demographic and medical data. Participants completed psychometric tests to assess their pain (King's Parkinson's Disease Pain Questionnaire, McGill Pain Questionnaire and Brief Pain Inventory), psychological distress (Beck Depression Inventory and Parkinson Anxiety Scale), pain coping strategies (Coping Strategies Questionnaire) and pain catastrophizing (Pain Catastrophizing Scale). RESULTS Depending on the tool used, 82.8% to 95.2% of participants reported pain. 23.5 % and 67.5% of participants showed respectively significant levels of depressive and anxiety symptoms. Psychological distress was significantly correlated with the quality of pain (both sensory and affective dimensions). Statistical models highlighted the mediating role of catastrophizing in the relationship between psychological distress and pain in Parkinson's. CONCLUSION These findings offer new perspectives toward understanding the underlying mechanisms of pain in Parkinson's and for effective therapeutic intervention goals to facilitate adaptation to pain symptoms in Parkinson's.
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Affiliation(s)
- Sylvia Zimmers
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
| | - Léonore Robieux
- Laboratoire de Psychopathologie et Processus de Changement, Université Paris 8- IED, Saint-Denis, France
| | - Catherine Bungener
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
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Adams GR, Gandhi W, Harrison R, van Reekum CM, Wood-Anderson D, Gilron I, Salomons TV. Do "central sensitization" questionnaires reflect measures of nociceptive sensitization or psychological constructs? A systematic review and meta-analyses. Pain 2023; 164:1222-1239. [PMID: 36729810 DOI: 10.1097/j.pain.0000000000002830] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/21/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Central sensitization (CS) is defined as an increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state associated with noxious inputs (eg, polyarthritis). The concept of CS has recently been adopted in clinical assessments of chronic pain, but its diagnosis in humans may now include a wide range of hypervigilant responses. The purpose of this review is to ascertain whether self-report questionnaires linked with CS are associated with enhanced nociceptive responses or whether they measure sensitivity in a broader sense (ie, emotional responses). According to our published, PROSPERO-registered review protocol (CRD42021208731), a predefined search of studies that involve the Central Sensitization Inventory (CSI) or Pain Sensitivity Questionnaire (PSQ), correlated with either nociceptive sensory tests or emotional hypervigilance was conducted on MEDLINE, PsycINFO, and Web of Science. Correlations between the CSI or PSQ with our primary outcomes were extracted and meta-analysed. A review of 66 studies totalling 13,284 participants found that the CSI (but not the PSQ) strongly correlated with psychological constructs: depression, anxiety, stress, pain catastrophising, sleep, and kinesiophobia. The CSI and PSQ showed weak or no correlations with experimental measures of nociceptive sensitivity: pain thresholds, temporal summation, or conditioned pain modulation. The PSQ did, however, correlate strongly with phasic heat and tonic cold pain tests. The studies reviewed did not provide sufficient evidence that self-report measures reflect a canonical understanding of CS. The CSI more closely reflects psychological hypervigilance than increased responsiveness of nociceptive neurons.
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Affiliation(s)
- Greig R Adams
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Wiebke Gandhi
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Richard Harrison
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada
| | - Tim V Salomons
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Gupta CC, Sprajcer M, Johnston-Devin C, Ferguson SA. Sleep hygiene strategies for individuals with chronic pain: a scoping review. BMJ Open 2023; 13:e060401. [PMID: 36731933 PMCID: PMC9896248 DOI: 10.1136/bmjopen-2021-060401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Up to a quarter of the world's population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain. DESIGN This scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain. RESULTS Thirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy. CONCLUSION This scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.
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Affiliation(s)
- Charlotte C Gupta
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Colleen Johnston-Devin
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
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Association between sleep disturbances and pain subtypes in Parkinson’s disease. Neurol Sci 2022; 43:4785-4790. [DOI: 10.1007/s10072-022-06030-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/19/2022] [Indexed: 10/18/2022]
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Naisby J, Amjad A, Ratcliffe N, Yarnall AJ, Rochester L, Walker R, Baker K. A Survey of People With Parkinson's and Their Carers: The Management of Pain in Parkinson's. J Geriatr Psychiatry Neurol 2022; 35:613-621. [PMID: 34235999 PMCID: PMC9210119 DOI: 10.1177/08919887211023592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Pain in Parkinson's is problematic but under treated in clinical practice. Healthcare professionals must understand the impact of pain in Parkinson's and patient preferences for management. OBJECTIVE To understand the impact of pain in Parkinson's and to understand current management and preferences for pain management. METHODS We conducted a national survey with 115 people with Parkinson's (PwP) and 10 carers. Both closed and open questions were used. The questions focused on how pain affected the individual, healthcare professional involvement in supporting pain management, current pain management strategies and views on future pain management interventions. We used descriptive statistics to summarize closed responses and thematic analysis to summarize open question responses. RESULTS 70% of participants reported pain impacted their daily life. Pain had a multifactorial impact on participants, affecting movement, mood and quality of life. Improved pain management was viewed to have the potential to address each of these challenges. Pain affected a number of different sites, with low back pain and multiple sites being most frequently reported. Exercise was the most frequently noted strategy (38%) recommended by healthcare professionals for pain management. PwP would value involvement from healthcare professionals for future pain management, but also would like to self-manage the condition. Medication was not suggested as a first line strategy. CONCLUSIONS Despite reporting engagement in some strategies to manage pain, pain still has a wide-ranging impact on the daily life of PwP. Results from this survey highlight the need to better support PwP to manage the impact of pain.
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Affiliation(s)
- Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, United Kingdom,Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Newcastle University, Newcastle Upon Tyne, United Kingdom,Jenni Naisby, Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, United Kingdom.
| | | | | | | | - Lynn Rochester
- Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, United Kingdom
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Nagaki K, Fujioka S, Sasai H, Yamaguchi Y, Tsuboi Y. Physical Activity and Its Diurnal Fluctuations Vary by Non-Motor Symptoms in Patients with Parkinson's Disease: An Exploratory Study. Healthcare (Basel) 2022; 10:healthcare10040749. [PMID: 35455926 PMCID: PMC9029803 DOI: 10.3390/healthcare10040749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background: This exploratory study investigated the association between non-motor symptoms (NMS) and both physical activity and diurnal activity patterns in patients with Parkinson’s disease (PwPD). Methods: Participants included PwPD with modified Hoehn and Yahr stages 1−3. The presence of NMS was assessed with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I. Physical activity was measured using a waist-mounted triaxial accelerometer. Logistic regression analyses evaluated associations between NMS and physical activity; furthermore, diurnal fluctuation in physical activity due to NMS was examined by ANCOVA. Results: Forty-five PwPD were included in the study. Among the domains of NMS, pain and other sensations (OR, 8.36; 95% CI, 1.59−43.94) and fatigue (OR, 14.26; 95% CI, 1.85−109.90) were associated with low daily step count (<4200 steps/day). Analysis by time of day showed no characteristic variability in physical activity but had constant effect sizes for pain and other sensations (p = 0.20, ES = 0.36) and fatigue (p = 0.08, ES = 0.38). Conclusion: Our exploratory study suggested that PwPD with pain and other sensations and fatigue recorded lower step counts than their asymptomatic counterparts. Therefore, PwPD with pain and fatigue may need more support in promoting physical activity.
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Affiliation(s)
- Koichi Nagaki
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (K.N.); (S.F.); (Y.Y.)
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (K.N.); (S.F.); (Y.Y.)
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan;
| | - Yumiko Yamaguchi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (K.N.); (S.F.); (Y.Y.)
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (K.N.); (S.F.); (Y.Y.)
- Correspondence: ; Tel.: +81-92-801-1011
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Gao L, Huang W, Cai L, Peng Y. Pain Assessment in Chinese Parkinson’s Disease Patients Using King’s Parkinson’s Disease Pain Scale. J Pain Res 2022; 15:715-722. [PMID: 35300403 PMCID: PMC8922447 DOI: 10.2147/jpr.s353249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Liang Gao
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Weiling Huang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Laisheng Cai
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Yufen Peng
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
- Correspondence: Yufen Peng; Liang Gao, Tel +86 791-88692511, Email ;
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