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Rukavina K, Mulholland N, Corcoran B, Skoric MK, Staunton J, Rota S, Zinzalias P, Wu K, Fieldwalker A, Bannister K, Rizos A, Chaudhuri KR. Musculoskeletal pain in Parkinson's disease: Association with dopaminergic deficiency in the caudate nucleus. Eur J Pain 2024; 28:244-251. [PMID: 37587725 DOI: 10.1002/ejp.2172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Musculoskeletal (MSK) pain affects over 80% of People with Parkinson's (PD, PwP) and may, in part, be dopaminergic in origin, as dopaminergic medication often leads to its relief. METHODS PwP who underwent striatal dopamine transporter visualization with a radiopharmaceutical DaTscan™ (123 I-Ioflupane Injection) using a single-photon emission computed tomography (SPECT) as a part of their clinical-diagnostic work up were enrolled in the "Non-motor International Longitudinal Study" (NILS; UK National Institute for Health Research Clinical Research Network Number 10084) and included in this cross-sectional analysis. The association between specific DaTscan binding ratios for each striatum, the caudate nucleus and putamen and clinical ratings for MSK pain (assessed using the King's Parkinson's Disease Pain Scale (KPPS)) were analysed. RESULTS 53 PwP (30.2% female; age: 63.79 ± 11.31 years; disease duration (DD): 3.32 (0.31-14.41) years; Hoehn & Yahr stage (H&Y): 2 (1-4); Levodopa Equivalent Daily Dose (LEDD): 543.08 ± 308.94 mg) were assessed and included in this analysis. MSK pain was highly prevalent (71.7% of all participants, mean KPPS Item 1 score 5.34 ± 4.76) and did not correlate with the motor symptoms burden (SCOPA-Motor total score; p = 0.783) but showed a significant correlation with quality of life (PDQ-8, rs = 0.290, p = 0.035). z-scores for the caudate nucleus (Exp (B) = 0.367, 95% CI for Exp (B) 0.148-0.910, p = 0.031) and striatum (Exp (B) = 0.338, 95% CI for Exp (B) 0.123-0.931, p = 0.036), adjusted for DD, H&Y and LEDD, were significant determinants of MSK pain. CONCLUSIONS Our findings suggest an association between MSK pain in PwP and the severity of dopaminergic deficiency in the caudate nucleus. SIGNIFICANCE In People with Parkinson's, musculoskeletal pain does not arise simply as a direct sequel to motor symptoms-instead, it is linked to the severity of dopaminergic depletion in the caudate nucleus.
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Affiliation(s)
- Katarina Rukavina
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - Nicola Mulholland
- Department of Nuclear Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Benjamin Corcoran
- Department of Nuclear Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Magdalena Krbot Skoric
- Laboratory for Cognitive and Experimental Neurophysiology, Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Juliet Staunton
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - Silvia Rota
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - Pavlos Zinzalias
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - Kit Wu
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - Anna Fieldwalker
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
| | - Kirsty Bannister
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
| | - Alexandra Rizos
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
| | - K Ray Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK
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Wahid SS, Pedersen GA, Ottman K, Burgess A, Gautam K, Martini T, Viduani A, Momodu O, Lam C, Fisher HL, Kieling C, Adewuya AO, Mondelli V, Kohrt BA. Detection of risk for depression among adolescents in diverse global settings: protocol for the IDEA qualitative study in Brazil, Nepal, Nigeria and the UK. BMJ Open 2020; 10:e034335. [PMID: 32723734 PMCID: PMC7389769 DOI: 10.1136/bmjopen-2019-034335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Globally, depression is a leading cause of disability among adolescents, and suicide rates are increasing among youth. Treatment alone is insufficient to address the issue. Early identification and prevention efforts are necessary to reduce morbidity and mortality. The Identifying Depression Early in Adolescence (IDEA) consortium is developing risk detection strategies that incorporate biological, psychological and social factors that can be evaluated in diverse global populations. In addition to epidemiological and neuroscience research, the IDEA consortium is conducting a qualitative study to explore three domains of inquiry: (1) cultural heterogeneity of biopsychosocial risk factors and lived experience of adolescent depression in low-income and middle-income countries (LMIC); (2) the feasibility, acceptability and ethics of a risk calculator tool for adolescent depression that can be used in LMIC and high-income countries and (3) capacity for biological research into biomarkers for depression risk among adolescents in LMIC. This is a multisite qualitative study being conducted in Brazil, Nepal, Nigeria and the UK. METHODS AND ANALYSIS A systematic set of qualitative methods will be used in this study. The Delphi method, Theory of Change (ToC) workshops, key-informant interviews and focus group discussions will be used to elicit perspectives on the study topics from a broad range of stakeholders (adolescents, parents, policy-makers, teachers, health service providers, social workers and experts). Delphi panellists will participate in three survey rounds to generate consensus through facilitated feedback. Stakeholders will create ToC models via facilitated workshops in the LMIC sites. The framework approach will be used to analyse data from the study. ETHICS AND DISSEMINATION Ethical approvals were received from the Ethics Review Board of George Washington University and from site-specific institutions in Brazil, Nepal, Nigeria and the UK. The findings generated from this study will be reported in highly accessed, peer-reviewed, scientific and health policy journals.
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Affiliation(s)
- Syed Shabab Wahid
- Division of Global Mental Health, George Washington University, Washington, District of Columbia, USA
| | - Gloria A Pedersen
- Division of Global Mental Health, George Washington University, Washington, District of Columbia, USA
| | - Katherine Ottman
- Division of Global Mental Health, George Washington University, Washington, District of Columbia, USA
| | - Abigail Burgess
- SGDP Centre, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - Thais Martini
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Anna Viduani
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Olufisayo Momodu
- Department of Psychiatry, Lagos Island General Hospital, Lagos, Nigeria
| | - Crystal Lam
- Department of Global Health, George Washington University, Washington, District of Columbia, USA
| | - Helen L Fisher
- SGDP Centre, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
| | - Christian Kieling
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Valeria Mondelli
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington, District of Columbia, USA
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Staite E, Zaremba N, Macdonald P, Allan J, Treasure J, Ismail K, Stadler M. 'Diabulima' through the lens of social media: a qualitative review and analysis of online blogs by people with Type 1 diabetes mellitus and eating disorders. Diabet Med 2018; 35:1329-1336. [PMID: 29855073 DOI: 10.1111/dme.13700] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 11/30/2022]
Abstract
AIMS To perform a qualitative review of online blogs authored by people self-identifying as having Type 1 diabetes and an eating disorder or 'diabulimia', a term used by people with Type 1 diabetes to describe an eating disorder that is characterized by deliberate restriction of insulin to control weight. METHODS We conducted a structured qualitative review of online blogs published between 2012 and 2017 authored by people who report having Type 1 diabetes and an eating disorder or diabulimia. The subsequent thematic analysis followed a six-phase process and was conducted by two independent researchers. RESULTS From 147 000 search results, 11 blogs (304 posts) matched criteria for further analyses. Three key themes and 18 subthemes emerged: 1) different aspects of bloggers' relationship with insulin, including motives for omitting insulin, secrecy of insulin omission and perception of control; 2) bloggers' experiences of diabetes complications, and diabetes ketoacidosis in particular, as well as their worries about future complications; 3) strategies for recovery and triggers for relapse, which involved diabetes self-management and setting up a support system. CONCLUSIONS Qualitative analyses of blogs authored by people with Type 1 diabetes and an eating disorder or diabulimia have identified high levels of diabetes distress and provided insight into different motives for insulin omission and strategies for recovery. Considering the limited evidence for effective interventions, these findings may help the development of complex interventions to improve biomedical and psychological outcomes in this group.
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Affiliation(s)
- E Staite
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, UK
| | - N Zaremba
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, UK
| | - P Macdonald
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Allan
- Birkbeck, University of London, London, UK
| | - J Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K Ismail
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, UK
| | - M Stadler
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
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