Abstract
Pain is an important and distressing symptom in Parkinson’s disease (PD). Our aim was to determine the prevalence of pain, its various types and characteristics, as well as its impact on depression and quality of life (QoL) in patients with PD. How pain differs in early- and advanced-stage PD and male and female PD patients was of special interest. One hundred PD patients on dopaminergic medications had a neurological examination and participated in a structured interview on pain characteristics and completed standardized questionnaires. A total of 76% of the patients had pain. The following types of pain were present: musculoskeletal pain accounted for 41% of the total pain, dystonic pain for 17%, central neuropathic pain for 22%, radicular pain for 27%, and other pains (non-radicular low back pain, arthritic, and visceral pain) made up 24%. One type of pain affected 29% of all the subjects, two types 35%, three types 10%, and four types of pain were reported by 2%. All types of pain were more prevalent in advanced-stage PD subjects than in early-stage PD subjects, except for arthritic pain (subclassified under”other pain”). The frequency and intensity of actual, average, and worst experienced pain were significantly more severe in advanced-stage subjects. PD subjects with general pain and in advanced stages were more depressed and had poorer QoL. Depression correlated with worst pain in the last 24 hours and with pain periodicity (the worst depression score in patients with constant pain). QoL correlated with average pain in the last 7 days. Pain is a frequent problem in PD patients, and it worsens during the course of the disease.
Highlights
Parkinson’s disease (PD) is a complex disorder characterized by various motor, sensory, autonomic, and psychiatric signs and symptoms [1]
The aim of this study was to determine the prevalence of pain, its various types and characteristics, and its impact on depression and quality of life in PD patients
In this cross-sectional study of pain in PD we found that 74% of PD subjects on dopaminergic medication had experienced some type of pain
Summary
Parkinson’s disease (PD) is a complex disorder characterized by various motor, sensory, autonomic, and psychiatric signs and symptoms [1]. The obviously discrepant findings are a result of the differences in sample sizes, scales, and classifications of types of pain [2,3,4,5,6,7,8,9,10,11]. Deuschl and Wassner [12] recommended that pain be divided into nociceptive (musculoskeletal, visceral, cutaneous) and neuropathic (peripheral, central) types. Ford’s pain classification from 2010 [14] remains the most-cited one. It distinguishes among five crucial types of pain in PD—according to their origin, as well as the treatment approach (Table 2)
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