Relationship between pain and motor and non‐motor symptoms in Parkinson's disease

Defazio, Giovanni; Antonini, Angelo; Tinazzi, Michèle; Gigante, Angelo Fabio; Pietracupa, Sara; Pellicciari, Roberta; Bloise, Maria; Bacchin, Ruggero; Marcante, Andrea; Fabbrini, Giovanni; Berardelli, Alfredo

doi:10.1111/ene.13323

Cited by 29 publications

(32 citation statements)

References 21 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most neurologists treat patients with chronic pain, but few have received any training in this area, underscoring a clear educational need. Nevertheless, pain is frequently under‐recognized and often not reported by patients and, because it can have such an impact on daily quality of life, it is incumbent on clinicians to investigate its presence and assess it in relation to the whole spectrum of non‐motor symptoms . Clinicians should try to understand what type of pain the patient is suffering because the underlying mechanisms and treatment options vary.…”

Section: Management Of Pain In Clinical Practicementioning

confidence: 99%

Pain in Parkinson's disease: facts and uncertainties

Antonini

Tinazzi

Abbruzzese

et al. 2018

Euro J of Neurology

Self Cite

View full text Add to dashboard Cite

Pain is one of the most common and troublesome non-motor symptoms of Parkinson's disease (PD). It can appear at any time during the disease and is often present before diagnosis. However, there is little or no consensus on its definition. An expert group of clinicians with relevant research experience met to review the existing evidence and to identify gaps in our understanding leading towards AUTHOR: 'understanding towards' has been changed to 'understanding leading towards'. Please check and confirm that this is appropriate an optimized therapy of pain in PD. Key findings from epidemiologic, neurophysiologic, neuroimaging and clinical studies are reviewed. In each case, the evidence base is limited by wide variations in the definitions of pain applied, study methodologies and populations evaluated. Disease-related and medical conditions trigger spontaneous pain in patients with PD, which is then abnormally processed and results in painful manifestations in specific body parts. Dopaminergic medications, such as rotigotine, as well as opiate analgesics, such as oxycodone, have shown positive results but future studies with more detailed pain characterization at inclusion are warranted.

show abstract

Section: Management Of Pain In Clinical Practicementioning

confidence: 99%

Pain in Parkinson's disease: facts and uncertainties

Antonini

Tinazzi

Abbruzzese

et al. 2018

Euro J of Neurology

Self Cite

View full text Add to dashboard Cite

show abstract

“…In general population, sleep disturbances and pain are frequent co-morbidities. There is evidence from experimental and longitudinal studies that pain and sleep interact in a bidirectional manner and negatively affect each other.11 In PD, studies have shown that sleep disturbances are a risk factor for pain and vice versa 10,12–16…”

Section: Introductionmentioning

confidence: 99%

<p>Sleep disturbances in Parkinson’s disease are associated with central parkinsonian pain</p>

Vila‐Chã¹,

Cavaco²,

Mendes³

et al. 2019

JPR

View full text Add to dashboard Cite

Introduction Sleep disturbances and pain are common non-motor symptoms in Parkinson’s disease (PD). This study aimed to explore the association between these two symptoms in a cohort of patients with PD. Materials and methods The Parkinson’s Disease Sleep Scale (PDSS-2) was used to identify sleep disturbances in a series of 229 PD patients. The identification and characterization of pain was performed by a semi-structured interview and by the application of the Ford classification and the Brief Pain Inventory (BPI). The Unified Parkinson’s Disease Rating Scale-III, Hoehn & Yahr (H&Y), and Schwab and England Independence Scale were used to assess motor symptoms and functional independence in off and on conditions. The Hospital Anxiety and Depression Scale (HADS) and SF-36 were applied to screen for anxiety and depression and to evaluate the quality of life. Non-parametric tests were used for group comparisons and logistic regressions were applied to explore predictors of sleep disturbances. Results Seventy-five (33%) patients had clinically relevant sleep disturbances (PDSS-2≥18) and 162 patients (71%) reported pain. Of those with pain, 38 (24%) had central parkinsonian pain. PD patients with sleep disturbances experienced more pain and had more severe motor symptoms, lower functional independence, more anxiety and depression symptoms, and worst quality of life. Among patients with pain, central parkinsonian pain was the subtype of pain with the highest odds of sleep disturbances, even when taking into account motor symptoms (H&Y off), motor fluctuations, intensity of pain (BPI), and symptoms of anxiety and depression (HADS). Conclusions The association between pain and sleep disturbances in PD appears to be dependent on subtype of pain. The close relationship between central parkinsonian pain and sleep disturbances in PD raises the possibility of common pathophysiological mechanisms. A better understanding of the relationship between sleep disturbances and central parkinsonian pain may contribute to the development of new care strategies in PD patients.

show abstract

“…In line with the abovementioned link between network integration and cognition, cognitive decline in PD has been associated with decreased functional connectivity (Olde Dubbelink et al, 2014 ; Amboni et al, 2015 ) or deviant coupling between subnetworks of the brain (Putcha et al, 2016 ). Another non-motor symptom is pain (Broen et al, 2012 ; Choi et al, 2017 ), a symptom that is present in about two thirds of patients and has been associated with sleep and mood disturbances, as well as severity of motor symptoms (Broen et al, 2012 ; Defazio et al, 2017 ). Pain in PD has been linked to a functional disconnection between the hippocampus and nucleus accumbens (Polli et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Dynamic Functional Connectivity and Symptoms of Parkinson’s Disease: A Resting-State fMRI Study

Engels

Vlaar

McCoy

et al. 2018

Front. Aging Neurosci.

View full text Add to dashboard Cite

Research has shown that dynamic functional connectivity (dFC) in Parkinson’s disease (PD) is associated with better attention performance and with motor symptom severity. In the current study, we aimed to investigate dFC of both the default mode network (DMN) and the frontoparietal network (FPN) as neural correlates of cognitive functioning in patients with PD. Additionally, we investigated pain and motor problems as symptoms of PD in relation to dFC. Twenty-four PD patients and 27 healthy controls participated in this study. Memory and executive functioning were assessed with neuropsychological tests. Pain was assessed with the Numeric Rating Scale (NRS); motor symptom severity was assessed with the Unified Parkinson’s Disease Rating Scale (UPDRS). All subjects underwent resting-state functional magnetic resonance imaging (fMRI), from which dFC was defined by calculating the variability of functional connectivity over a number of sliding windows within each scan. dFC of both the DMN and FPN with the rest of the brain was calculated. Patients performed worse on tests of visuospatial memory, verbal memory and working memory. No difference existed between groups regarding dFC of the DMN nor the FPN with the rest of the brain. A positive correlation existed between dFC of the DMN and visuospatial memory. Our results suggest that dynamics during the resting state are a neural correlate of visuospatial memory in PD patients. Furthermore, we suggest that brain dynamics of the DMN, as measured with dFC, could be a phenomenon specifically linked to cognitive functioning in PD, but not to other symptoms.

show abstract

Relationship between pain and motor and non‐motor symptoms in Parkinson's disease

Abstract: We confirm that pain in PD is more frequent in women and in subjects with medical conditions predisposing to painful symptoms. Moreover, this strengthens the association between pain and motor severity measures and NMS domains, particularly sleep and mood disturbances.

Cited by 29 publications

References 21 publications

Pain in Parkinson's disease: facts and uncertainties

Pain in Parkinson's disease: facts and uncertainties

<p>Sleep disturbances in Parkinson’s disease are associated with central parkinsonian pain</p>

Dynamic Functional Connectivity and Symptoms of Parkinson’s Disease: A Resting-State fMRI Study

Contact Info

Product

Resources

About