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Hoang DT, Xing F, Nguyen TD, Nguyen TD, Tran TN, Nhu SD, Nguyen QH, Nguyen HT, Hoang UT, Than QV, Truong D. Pain is common in early onset Parkinson's disease and pain severity is associated with age and worsening of motor and non-motor symptoms. J Neurol Sci 2023; 455:122784. [PMID: 38043181 DOI: 10.1016/j.jns.2023.122784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023]
Abstract
The consequences of pain in early onset Parkinson's disease (EOPD) remain under appreciated even though pain may exert an increasingly negative impact on patient quality of life as motor and non-motor symptoms worsen. In this prospective study, we investigate the prevalence and severity of pain in 135 Vietnamese patients with EOPD from three medical centers using the King's PD Pain Scale (KPPS), the Mini Mental Status Exam (MMSE), the Unified Parkinson's Disease Rating Scale (UPDRS) and the Non-Motor Symptoms Scale (NMSS). Pain was reported by 79.3%. The most common subtype of pain was musculoskeletal (70.1%), followed by nocturnal (43.9%), radicular (43.0%), chronic (42.1%), fluctuation-related (34.6%) and orofacial pain (16.8%). Most patients (74.8%) experienced more than one pain subtype. Fluctuation-related pain and orofacial pain were significantly more prevalent among patients with higher Hoehn & Yahr (H&Y) stages (3-5) versus lower H&Y stages (1-2). Pain subtype and severity were not significantly related to gender or age of PD onset. Patients with H&Y stages 3-5 had statistically significantly higher KPPS scores for fluctuation-related pain (p = 0.018) and radicular pain (p = 0.026). Independent associations were found between pain severity and age (p = 0.028), depression severity (p = 0.018), perceptual problems/hallucinations (p = 0.033) and sexual function (p = 0.024). Patients with depression and higher H&Y stages (3-5) had statistically significantly higher mean KPPS scores versus patients without depression and at lower H&Y stages (1-2). Pain may be more common and severe in EOPD patients than previously appreciated. Older age, depression, perceptual problems/hallucinations and sexual dysfunction were independently associated with higher pain severity.
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Affiliation(s)
- Dung Thi Hoang
- Department of Neurology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Viet Nam.
| | - Frank Xing
- The Truong Neuroscience Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA.
| | - Thuan Duc Nguyen
- Department of Neurology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Viet Nam.
| | - Ton Dang Nguyen
- Institute of Genome Research, Vietnam Academy of Science and Technology, Cau Giay, Hanoi, Viet Nam.
| | - Tai Ngoc Tran
- University Medical Center HCMC, University of Medicine and Pharmacy at HCMC, Ho Chi Minh City, Viet Nam.
| | - Son Dinh Nhu
- Department of Neurology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Viet Nam
| | | | - Hai Thanh Nguyen
- Department of Neurology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Viet Nam
| | - Ung Tien Hoang
- Department of Rehabilitation, Military Hospital 103, Vietnam Military Medical University, Hanoi, Viet Nam
| | | | - Daniel Truong
- The Truong Neurosciences Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA; Department of Neurosciences, UC Riverside, Riverside, CA, United States of America.
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