Fluctuating pain in Parkinson's disease: Its prevalence and impact on quality of life

Kurihara, Kanako; Fujioka, Shinsuke; Kawazoe, Miki; Mishima, Takayasu; Ouma, Shinji; Tsuboi, Yoshio

doi:10.1016/j.ensci.2021.100371

Cited by 3 publications

(1 citation statement)

References 40 publications

(44 reference statements)

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“…They found that patients with H&Y stage more than 2.5 had a higher percentage of fluctuation-related pain. [30] Another study demonstrated a lower frequency of fluctuation related pain with higher age of onset. [23] This could partially explain the high prevalence of fluctuation-related pain in our study since 50.5% of the patients had H&Y scores of more than 2.5 and 34.4 % had an early-onset PD.…”

Section: Discussionmentioning

confidence: 97%

Pain characteristics of Parkinson’s disease using validated Arabic versions of the King’s Parkinson’s Disease Pain Scale and Questionnaire: A Multicenter Egyptian Study

Shalash,

Mohamed,

Badr

et al. 2024

JMD

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Section: Discussionmentioning

confidence: 97%

Pain characteristics of Parkinson’s disease using validated Arabic versions of the King’s Parkinson’s Disease Pain Scale and Questionnaire: A Multicenter Egyptian Study

Shalash,

Mohamed,

Badr

et al. 2024

JMD

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Pain in Parkinson's disease: a neuroanatomy-based approach

Nardelli,

Gambioli,

De Bartolo

et al. 2024

Brain Communications

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Parkinson’s Disease is a progressive neurodegenerative disorder characterized by the deposition of misfolded alpha-synuclein in different regions of the central and peripheral nervous system. Motor impairment represents the signature clinical expression of Parkinson’s Disease. Nevertheless, non-motor symptoms are invariably present at different stages of the disease and constitute an important therapeutic challenge with a high impact for the patients’ quality of life. Among non-motor symptoms, pain is frequently experienced by patients, being present in a range of 24%-85% of Parkinson’s Disease population. Moreover, in more than 5% of patients, pain represents the first clinical manifestation, preceding by decades the exordium of motor symptoms. Pain implies a complex biopsychosocial experience with a downstream complex anatomical network involved in pain perception, modulation, and processing. Interestingly, all the anatomical areas involved in pain network can be affected by a-synuclein pathology, suggesting that pathophysiology of pain in Parkinson’s Disease encompasses a “pain spectrum”, involving different anatomical and neurochemical substrates. Here the various anatomical sites recruited in pain perception, modulation and processing are discussed, highlighting the consequences of their possible degeneration in course of Parkinson’s Disease. Starting from peripheral small fibers neuropathy and pathological alterations at the level of the posterior laminae of the spinal cord, we then describe the multifaceted role of noradrenaline and dopamine loss in driving dysregulated pain perception. Finally, we focus on the possible role of the intertwined circuits between amygdala, nucleus accumbens and habenula in determining the psycho-emotional, autonomic, and cognitive experience of pain in Parkinson’s Disease. This narrative review provides the first anatomically-driven comprehension of pain in Parkinson’s Disease, aiming at fostering new insights for personalized clinical diagnosis and therapeutic interventions.

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Pain Fluctuations in Parkinson’s Disease and Their Association with Motor and Non-Motor Fluctuations

Storch,

Bremer,

Gandor

et al. 2024

JPD

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Background: Pain fluctuations are a characteristic phenomenon in advanced Parkinson’s disease (PD), but their temporal association with motor and non-motor symptom (NMS) fluctuations remains largely enigmatic. Moreover, data on their importance for disease severity perception and health-related quality-of-life (hr-QoL) is limited. Objective: To dissect pain fluctuations with respect to pain type and frequency patterns, and their association with motor and non-motor fluctuations. Methods: Prospective observational cohort study in advanced PD assessing symptom fluctuations by simultaneous hourly ratings using the PD Home diary (Off, On, Dyskinetic state), a pain diary (assessing 9 pain types) and a non-motor diary (10 key NMS) based on validated instruments. Results: Forty-seven out of 55 eligible participants with fluctuating PD (51% men, median age 65, median disease duration 10 years) had sufficient datasets (>95% of hours) from 2 consecutive days. Pain was reported in 35% of waking hours with clear circadian rhythm peaking in early morning Off periods and clustering during motor Off state (49% of Off state hours with pain). Main NMS co-fluctuating with pain were “Fatigue” and “Inner Restlessness”. Simultaneous assessment of global disease severity by participants revealed that pain was associated with worse disease severity only in motor On and Dyskinetic state but not in Off state, which translated into significant correlations of daily pain times with hr-QoL only during motor On and Dyskinetic state. Conclusions: Aside from treating motor Off periods, specific recognition of pain particularly during motor On and Dyskinetic state comprises an important aspect for disease management in advanced PD.

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Fluctuating pain in Parkinson's disease: Its prevalence and impact on quality of life

Cited by 3 publications

References 40 publications

Pain characteristics of Parkinson’s disease using validated Arabic versions of the King’s Parkinson’s Disease Pain Scale and Questionnaire: A Multicenter Egyptian Study

Pain characteristics of Parkinson’s disease using validated Arabic versions of the King’s Parkinson’s Disease Pain Scale and Questionnaire: A Multicenter Egyptian Study

Pain in Parkinson's disease: a neuroanatomy-based approach

Pain Fluctuations in Parkinson’s Disease and Their Association with Motor and Non-Motor Fluctuations

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