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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.
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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
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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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Minibajeva O, Zeltiņa E, Karelis G, Kurjāne N, Ķēniņa V. Clinical Symptoms Influencing Parkinson's Patients' Quality of Life in Latvia: A Single-Center Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050935. [PMID: 37241166 DOI: 10.3390/medicina59050935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Parkinson's disease (PD) is a chronic, progressive illness with a profound impact on health-related quality of life, and it is crucial to know what factors influence the quality of life throughout the course of the disease. This study aimed to evaluate PD patients' motor and non-motor symptoms to compare symptom severity between PD clinical phenotypes and to assess the impact of disease symptoms on quality of life in a cohort of Latvian patients. Materials and Methods: We evaluated 43 patients with Parkinson's disease. Fourteen patients had tremor dominant (TD) PD, twenty-five patients had postural instability/gait difficulty (PIGD), and four patients had a mixed phenotype. Results: The patients' mean age was 65.21 years, and the disease's mean duration was 7 years. The most common non-motor symptoms were fatigue (95.3%), sleep disturbance (83.7%), daytime sleepiness (83.7%), and pain and other sensations (81.4%). PIGD patients had a higher prevalence of depressed mood, daytime sleepiness, constipation, lightheadedness on standing, cognitive impairment, and severe gastrointestinal and urinary disturbances (as assessed using the SCOPA-AUT domains) compared with TD patients. A high prevalence of fatigue was assessed in both disease subtypes. Health-related quality of life significantly statistically correlated with MDS-UPDRS parts III and IV (r = 0.704), the Hoehn and Yahr scale (r = 0.723), as well as the SCOPA-AUT scale's gastrointestinal (r = 0.639), cardiovascular (r = 0.586), thermoregulatory (r = 0.566) and pupillomotor domains (r = 0.597). Conclusions: The severity of motor symptoms, as well as non-motor symptoms, such as fatigue, apathy, sleep problems and daytime sleepiness, pain, and disturbances in gastrointestinal and cardiovascular function, negatively affect PD patients' health-related quality of life. Thermoregulatory and pupillomotor symptoms also significantly affect PD patients' well-being.
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Affiliation(s)
- Olga Minibajeva
- Department of Doctoral Studies, Rīga Stradiņš University, LV-1007 Rīga, Latvia
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1079 Rīga, Latvia
| | - Estere Zeltiņa
- Faculty of Medicine, Rīga Stradiņš University, LV-1007 Rīga, Latvia
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1079 Rīga, Latvia
- Department of Infectology, Rīga Stradiņš University, LV-1006 Rīga, Latvia
| | - Nataļja Kurjāne
- Department of Biology and Microbiology, Rīga Stradiņš University, LV-1007 Rīga, Latvia
| | - Viktorija Ķēniņa
- Department of Biology and Microbiology, Rīga Stradiņš University, LV-1007 Rīga, Latvia
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Kurihara K, Fujioka S, Mishima T, Tsuboi Y. Evaluation of perception threshold and pain in patients with Parkinson's disease using PainVision ®. Front Neurol 2023; 14:1130986. [PMID: 37213902 PMCID: PMC10196013 DOI: 10.3389/fneur.2023.1130986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Pain is one of the most frequent non-motor symptoms occurring in patients with Parkinson's disease (PD). Traditionally, the Visual Analog Pain Scale (VAS), Numerical Rating Scale (NRS), and Wong-Baker Faces Pain Rating Scale (FRS) have been used for clinical pain assessment, but these assessments are subjective at best. In contrast, PainVision® is a perceptual/pain analyzer that can quantitatively evaluate pain as "pain intensity" based on "current perception threshold" and "pain equivalent current." We evaluated the current perception threshold in all PD patients and pain intensity in PD patients with pain using PainVision®. Methods We recruited 48 patients with PD (PwPD) with pain and 52 PwPD without pain. For patients with pain, we measured current perception threshold, pain equivalent current, and pain intensity using PainVision®, in addition to evaluation by VAS, NRS, and FRS. For patients without pain, only current perception threshold was measured. Results There was no correlation with either VAS or FRS, whereas only weak correlation was identified for NRS (γ = -0.376) with pain intensity. Current perception threshold was positively correlated with duration of the disease (γ = 0.347) and the Hoehn and Yahr stage (γ = 0.259). As a quantitative evaluation of pain, pain intensity by PainVision® does not correlate with conventional subjective pain assessments. Discussion This new quantitative evaluation method of pain may be suitable as an evaluation tool for future intervention research. Current perception threshold in PwPD was related to the duration and severity of the disease and may be involved in peripheral neuropathy associated with PD.
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Lapa JDDS, da Cunha PHM, Teixeira MJ, Brito Medeiros VM, Fernandes AM, Silva de Morais AD, Graven-Nielsen T, Cury RG, Ciampi de Andrade D. Burst Transspinal Magnetic Stimulation Alleviates Nociceptive Pain in Parkinson Disease—A Pilot Phase II Double-Blind, Randomized Study. Neuromodulation 2022:S1094-7159(22)01331-9. [DOI: 10.1016/j.neurom.2022.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022]
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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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Li J, Zhu BF, Gu ZQ, Zhang H, Mei SS, Ji SZ, Liu SY, Han C, Chen HZ, Chan P. Musculoskeletal Pain in Parkinson's Disease. Front Neurol 2022; 12:756538. [PMID: 35126283 PMCID: PMC8813739 DOI: 10.3389/fneur.2021.756538] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Musculoskeletal pain is commonly experienced in patients with Parkinson's disease (PD). Few studies have investigated the clinical characteristics and risk factors associated with musculoskeletal pain. OBJECTIVES To investigate the distribution, clinical characteristics, and factors associated with musculoskeletal pain in a large sample of patients with PD. METHODS We enrolled 452 patients from two clinics and used a standardized questionnaire to collect demographic and clinical information. Musculoskeletal pain was diagnosed based on the Ford Classification System, and pain severity was assessed with the numeric rating scale (NRS). Multivariate regression models explored the association between clinical features of PD and quality of life and pain. RESULTS Two hundred and six patients (45.58%) reported musculoskeletal pain, typically in their lower limbs and backs. Levodopa resulted in a ≥30% reduction in pain intensity scores in 170 subjects. Female sex (odds ratio [OR], 1.57; 95% CI, 1.07-2.29) and Levodopa-equivalent daily doses (LEDDs; OR, 3.35; 95% CI, 1.63-6.59) were associated with an increased risk for musculoskeletal pain. Pain duration (p = 0.017), motor symptoms (p < 0.001), and depression (p < 0.001) were significantly associated with quality of life. CONCLUSIONS The lower limbs and back are common sites of musculoskeletal pain in patients with PD, and up to 82.52% of patients were responsive to Levodopa. Female sex and LEDDs are associated with musculoskeletal pain, suggesting that dopamine deficiencies, and not the motor and non-motor impairment, might be the most critical baseline risk factor of musculoskeletal pain.
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Affiliation(s)
- Jun Li
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China.,Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ben-Fan Zhu
- Department of Pain, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhu-Qin Gu
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Hui Zhang
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Shan-Shan Mei
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Shao-Zhen Ji
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Shu-Ying Liu
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Chao Han
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Huai-Zhen Chen
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Piu Chan
- Department of Neurology, Neurobiology, and Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Clinical and Research Center for Parkinson's Disease, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Synergistic antiallodynic and antihyperalgesic interaction between L-DOPA and celecoxib in parkinsonian rats is mediated by NO-cGMP-ATP-sensitive K + channel. Eur J Pharmacol 2020; 889:173537. [PMID: 32971091 DOI: 10.1016/j.ejphar.2020.173537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022]
Abstract
Pain is a usual and troublesome non-motor symptom of Parkinson's disease, with a prevalence of 29-82%. Therefore, it's vital to find pharmacological treatments for managing PD-associated pain symptoms, to improve patients' quality of life. For this reason, we tested the possible synergy between L-DOPA and celecoxib in decreasing allodynia and hyperalgesia induced by unilateral lesioning with 6-OHDA into the SNpc in rats. We also tested whether the antiallodynic and antihyperalgesic effect induced by combination of L-DOPA and celecoxib is mediated by the NO-cGMP-ATP-sensitive K+ channel pathway. Tactile allodynia and mechanical hyperalgesia were evaluated using von Frey filament. Isobolographic analyses were employed to define the nature of the drug interaction using a fixed dose ratio (0.5: 0.5). We found that acute and sub-acute (10-day) treatment with a single dose of L-DOPA (3-25 mg/kg, i. p.) or celecoxib (2.5-20 mg/kg, i. p.) induced a dose-dependent antiallodynic and antihyperalgesic effect in parkinsonian rats. Isobolographic analysis revealed that the ED50 values obtained by L-DOPA + celecoxib combination was significantly less than calculated additive values, indicating that co-administration of L-DOPA with celecoxib produces synergistic interactions in its antiallodynic and antihyperalgesic effect in animals with nigrostriatal lesions. Moreover, the antiallodynic and antihyperalgesic effects induced by L-DOPA + celecoxib combination were blocked by intrathecal pre-treatment with L-NAME, ODQ, and glibenclamide. Taken together, the data suggest that L-DOPA + celecoxib combination produces an antiallodynic and antihyperalgesic synergistic interaction at the systemic level, and these effects are mediated, at the central level, through activation of the NO-cGMP-ATP-sensitive K+ channel pathway.
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