Background & Aims

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor symptoms like bradykinesia, tremor, rigidity, and postural instability. Additionally, PD severely impacts physical abilities and independence. Pain, affecting 67.6% of PD patients, varies in form and presentation, and it is often underdiagnosed. This study investigates the association between pain and motor symptom severity in PD patients.

Methods

This analysis used data from a cross-sectional study on 52 Parkinson’s Disease (PD) patients conducted at Jena University Hospital, Germany. The dataset on Dryad included demographics, clinical reports, and assessments of coping strategies, quality of life, and pain. Descriptive statistics, a bivariate analysis, and an ordinal logistic regression model were executed to explore the association between pain and Motor Symptom Severity (MSS). A causal inference analysis identified potential confounders, and a sensitivity analysis assessed the impact of using pain intensity as an outcome. The E-value was calculated to evaluate the strength of association needed by an unmeasured confounder to nullify the observed association.

Results

50 Parkinson’s Disease (PD) patients were included, being 64% male, with an average age of 76.1 years. The sample included 20 patients without pain and 30 with pain. The bivariate analysis did not identify significant differences between pain and no-pain groups in disease duration, cognitive function, and non-motor symptoms. However, significant differences emerged in motor symptom severity, coping strategies, and several SF-36 domains (Physical and Social Functioning, Role Functioning, Energy/Fatigue, Pain, General Health, and Health Change). In the multivariate analysis, the estimate of Pain presence for low to medium motor symptom severity was OR 3.52 (95% CI:0.38 – 6.67), and the estimate for medium to severe was OR 5.44 (95% CI:2.03 – 8.86). In addition, being a male is associated with increased motor symptom severity OR 4.63 (95% CI:1.15-18.58).

Conclusions

Pain and MSS are associated with a stronger association in patients progressing from medium to severe MSS, following a dose-response relation. Prospective studies are needed to verify these findings.

References

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2.Mettler FA. The substantia nigra and parkinsonism. Trans Am Neurol Assoc. 1964;89:68–73.
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Presenting Author

Kevin Pacheco-Barrios

Poster Authors

Kevin Pacheco-Barrios

MD, MPH, MSc

Spaulding Rehabilitation Hospital, Harvard Medical School.

Lead Author

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Niels Pacheco-Barrios

Brigham and Women’s Hospital, Harvard Medical School

Lead Author

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Vivian D B Gagliardi

Hospital Israelita Albert Einstein, São Paulo, Brazil

Lead Author

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Roberta R. Grudtner

São Pedro Psychiatric Hospital, Secretaria Estadual da Saúde Rio Grande do Sul

Lead Author

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Iloba Gabriel Njokanma

Lagos State University Teaching Hospital, Lagos, Nigeria

Lead Author

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Ben Illigens

Beth Israel Deaconess Medical Center, Harvard Medical School

Lead Author

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John D. Rolston

Brigham and Women’s Hospital, Harvard Medical School

Lead Author

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Felipe Fregni

Spaulding Rehabilitation Hospital, Harvard Medical School.

Lead Author

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Topics

  • Epidemiology