Preceding pain symptoms and <scp>P</scp>arkinson's disease: a nationwide population‐based cohort study

Lin, Chin-Hsien; Wu, Ruey‐Meei; Chang, Hsing-Yi; Chiang, Yi-Te; Lin, Hsien-Ho

doi:10.1111/ene.12197

Cited by 62 publications

(44 citation statements)

References 34 publications

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“…This patient-completed screening tool was derived from the KPPS and allows for the direct declaration of the pain each patient experiences. Prevalent in the prodromal, early, advanced and palliative stages of PD, pain is one of its most important non-motor symptoms [27][28][29] and was described by James Parkinson himself in his case number 4 [30,31]. Neuropathological correlates of pain in early and untreated PD have been described [32], and pain is also featured as one of the most prevalent and troublesome symptoms in the late palliative stage of PD [28,33].…”

Section: Discussionmentioning

confidence: 99%

First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire

Martinez‐Martín

Rizos

Wetmore

et al. 2018

Euro J of Neurology

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Section: Discussionmentioning

confidence: 99%

First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire

Martinez‐Martín

Rizos

Wetmore

et al. 2018

Euro J of Neurology

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“…Sensory complaints, particularly pain, are one of the most common nonmotor symptoms; nearly 43% of patients with PD experience primary pain related to dysfunction of the nociceptive system in early PD stages, in which motor symptoms are not yet prominent 2, 3 . Furthermore, patients with PD present a reduction of the pain threshold for both thermal and pain stimulation 4, 5 .…”

Section: Introductionmentioning

confidence: 99%

Depression and Catechol-O-methyltransferase (COMT) genetic variants are associated with pain in Parkinson’s disease

Lin

Chaudhuri

Fan

et al. 2017

Sci Rep

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Pain is a distressing symptom of Parkinson disease (PD). We aim to determine whether the genetic variants of chronic pain-related genes contribute to pain in PD patients. We included 418 PD patients and evaluated pain severity on King’s PD pain scale. We genotyped rs6267, rs6269, rs4633, rs4818 and rs4680 of COMT, rs6746030 of SCN9A, and rs1799971 of OPRM1. In total, 193 participants (46.2%) experienced pain. Compared to pain-free PD patients, PD patients with pain had an earlier age of onset, longer disease duration, and higher depression and motor severity (P < 0.01). The frequencies of COMT rs4680 “A” allele were higher in PD patients with pain than those without pain (46.1% vs. 31.1%, P < 0.01). Pain severity was significantly associated with disease duration (P = 0.02), and COMT rs6267 T allele (P < 0.01). We stratified PD by status of depression and the association between COMT rs6267 “GT” genotype and pain severity remained significant (P < 0.01). Furthermore, pain severity was significantly higher in participants having COMT rs4680 “GG” and “GA” genpotypes than those having “AA” genotype (P = 0.04). We concluded that depression and COMT rs4680 “GG” and “GA” genotypes and COMT rs6267 “GT” genotype contribute to pain in PD patients.

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“…1 Sensory complaints, especially pain, are one of the most common nonmotor symptoms, and more than one-quarter of PD patients experience “primary pain” related to dysfunction of the nociceptive system in the early stages of PD when motor symptoms are not prominent. 2,3 However, nerve conduction studies (NCS) are usually normal in PD patients, except for large-fiber neuropathy related to long-term exposure to levodopa with increased homocysteine levels and vitamin B12 deficiency. 4 Taken together, the symptoms of pain at early or premotor stage of PD raise the possibility of small-fiber sensory dysfunctions in either peripheral or central compartments of the nociceptive pathways during the early course of PD.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Small-Fiber Sensory System in Parkinson's Disease

Lin

Chao

et al. 2016

Medicine

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Sensory symptoms are frequent nonmotor complaints in patients with Parkinson's disease (PD). However, few investigations integrally explored the physiology and pathology of the thermonociceptive pathway in PD. We aim to investigate the involvement of the thermonociceptive pathway in PD.Twenty-eight PD patients (16 men, with a mean age and standard deviation of 65.6 ± 10.7 years) free of neuropathic symptoms and systemic disorders were recruited for the study and compared to 23 age- and gender-matched control subjects (12 men, with a mean age and standard deviation of 65.1 ± 9.9 years). We performed skin biopsy, contact heat-evoked potential (CHEP), and quantitative sensory tests (QST) to study the involvement of the thermonociceptive pathway in PD.The duration of PD was 7.1 ± 3.2 (range 2–17 years) years and the UPDRS part III score was 25.6 ± 9.7 (range 10–48) during the off period. Compared to control subjects, PD patients had reduced intra-epidermal nerve fiber (IENF) density (2.48 ± 1.65 vs 6.36 ± 3.19 fibers/mm, P < 0.001) and CHEP amplitude (18.02 ± 10.23 vs 33.28 ± 10.48 μV, P < 0.001). Twenty-three patients (82.1%) had abnormal IENF densities and 18 (64.3%) had abnormal CHEP. Nine patients (32.1%) had abnormal thermal thresholds in the feet. In total 27 patients (96.4%) had at least 1 abnormality in IENF, CHEP, or thermal thresholds of the foot, indicating dysfunctions in the small-fiber nerve system. In control subjects, CHEP amplitude linearly correlated with IENF density (P < 0.001). In contrast, this relationship disappeared in PD (P = 0.312) and CHEP amplitude was negatively correlated with motor severity of PD independent of age, gender, and anti-PD medication dose (P = 0.036), suggesting the influences of central components on thermonociceptive systems in addition to peripheral small-fiber nerves in PD.The present study suggested impairment of small-fiber sensory system at both peripheral and central levels is an intrinsic feature of PD, and skin biopsy, CHEP, and QST provided an integral approach for assessing such dysfunctions.

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Preceding pain symptoms and Parkinson's disease: a nationwide population‐based cohort study

Abstract: These findings support the hypothesis that pain is associated with PD in the pre-motor stage of the disease. Further research is needed to clarify the role of sensory system involvement in the pre-motor phase of PD.

Cited by 62 publications

References 34 publications

First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire

First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire

Depression and Catechol-O-methyltransferase (COMT) genetic variants are associated with pain in Parkinson’s disease

Pathophysiology of Small-Fiber Sensory System in Parkinson's Disease

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