P.043 Perceptual descriptors and clinical determinants of pain in Parkinson’s disease: focus on patients’ experiences

Abstract

Background: Pain is a disabling non-motor symptom of Parkinson’s disease (PD), which remains underacknowledged, undertreated and often undeclared by patients in the clinical practice. Prevalence of pain ranges from 40-75% among PD patients; however, clinical determinants and self-reported perceptual experiences of pain require further research. Methods: 121 PD patients (age: 67.3±11.4) from community-based clinic were analyzed cross-sectionally. Perceptual experiences and clinical predictors of pain were assessed using structured interviews, questionnaires and neurological examinations. Results: 80 (66%) PD patients reported pain; 65 (54%) described the severity as ‘moderate/high’. Dystonic was the most frequent clinical pain 37/80 (48%), followed by neuropathic (36%), akathisia (29%) and musculoskeletal (28%). More than one type of clinical pain was assessed in 22 (28%) patients. Aching was the most common perceptual descriptor of pain (46%), followed by sharp/deep (30%), tension (18%) and dull (14%). PD localized on the right side quadrupled the odds of pain on the right (OR=4.4, 95%CI [1.1-18.2]); and pain described as ‘sharp’ predicted neuropathic pain (OR=5.6, 95%CI [1.1-29.2]). Pain prevalence also increased with progressive Hoehn-and-Yahr stage. Interestingly, only 51% of patients perceived effects of PD medications on pain symptomology. Conclusions: Perceptual descriptors of pain can provide novel approaches to classify, treat and manage PD. Longitudinal investigations with larger sample are warranted.