Pain in Parkinson's disease

Abstract

-Pain may precede the diagnosis in Parkinson's disease (PD). The goal of this study was to assess the pain in a group of 20 females and 30 males with PD, after excluding co-morbidities as causes. It was used the following tools: Unified Parkinson's Disease Rating Scale, McGill questionnaire and Beck Depression Inventory. In 27 patients (54%), the pain was associated with PD, occurring in 22 (44%) in the off period and 5 (10%) in both on and off periods. The off period resulted in an increased frequency of pain, which was related to stiffness. There was no association between pain and tremor in off period, neither between pain and Modified Hoehn and Yahr stage, nor the Schwab and England scale. It was not observed an association between pain and depression, neither between pain and dyskinesia. It was noticed the improvement in pain in 16 patients with levodopa (59.26%). Em 27 pacientes (54%), a dor associou-se com a DP, ocorrendo em 22 (44%) no período off e em 5 (10%) nos períodos on e off. o período off resultou num aumento da freqüência da dor, o qual se relacionou com a rigidez. Não houve associação entre dor e tremor no período off, estágio Hoehn e Yahr modificado, nem a escala de Schwab e England. Não foi observado associação entre dor e depressão, nem entre dor e discinesia. Foi observada a melhora da dor em 16 pacientes com levodopa (59.26%).PAlAvRAS-CHAvE: doença de Parkinson, dor, levodopa.

Subthalamic deep brain stimulation modulates small fiber–dependent sensory thresholds in Parkinson’s disease

“…NMS are thought to be present from the early stages of the disease and may be related to extension of Lewy pathology to the nondopaminergic neuronal pathway [38]. Chronic pain (CP) is one of the most frequent NMS, and it was found that 62% of a cohort of 450 PD patients had CP [20,27]. Mechanisms involved in pain symptoms and their relation to nigrostriatal dopaminergic insufficiency and motor impairment are still poorly understood [7,16].…”

Pain characterization in patients with Parkinson’s disease

“…The vast majority of patients in this study were in HY stage III and in the trembling group; however they were not correlated to the pain symptom. Similarly, the HY scale was not correlated to pain, probably because the vast majority of patients were in stages 2 and 2.5, representing minimally disabling stages 3 . Pain location in the 24 patients indicates as specific area with more frequent pain complaints the lumbar spine, followed by shoulder and arm.…”

“…Primary sensory disorders are described by 40 to 50% of PD patients and encompass numbness, tingling, burning, cold, heat and pain 2 . Most recurrent pain is pain in the limb affected for the longest time by motor PD symptoms 3 , being referred by approximately 30 to 50% of patients 4 . Some pain scales are very well known: visual analog scale (VAS), visual numeric scale (VNS) and pain scale represented by facial expressions, which are unidimensional tools to quantify pain intensity and severity.…”

“…A very popular multidimensional tool to quantify pain is the McGill questionnaire 6 . Although being internationally referred and used in the clinical practice, McGill questionnaire has been poorly explored to study PD pain 3 . So, this study aimed at characterizing pain in PD patients assisted by a specialized outpatient service.…”

Pain in Parkinson's Disease Associated withCOMTGene Polymorphisms

“…It is reported that positive relation had been found between PD pain and sex, age, depression, and disease severity [27, 28], but the converse results are also reported [29, 30]. In order to exclude the influence of clinical factors on pain, we applied age, sex, onset age of PD, duration of disease, duration of L-Dopa medication, and UPDRS as covariates when statistic analysis was performed on COMT polymorphisms.…”