Background & Aims

Parkinson´s disease (PD) is the second most frequent neurodegenerative disorder with a drastic increase in prevalence. While several innovative diagnostic and therapeutic approaches have been established for PD-associated motor symptoms, non-motor symptoms (NMS) often remain out of clinical focus despite their impact on patients` health-related quality of life. Pain is a particularly debilitating and frequent NMS in PD occurring in up to 85% of patients with PD [1]. In our prospective cross-sectional study, we comprehensively characterized PD-related pain in monocentrically recruited patients with PD using standardized tools of pain assessment and categorization.

Methods

One hundred fifty patients were systematically interviewed and filled in questionnaires for pain, depression, motor, and non-motor symptoms. Patients with PD-related pain (PD pain), patients without PD-related pain (no PD pain), and patients without pain (no pain) were compared.

Results

Pain was present in 108/150 (72%) PD patients, 90/150 (60%) patients were classified as having PD-related pain. The majority of patients with PD (67/90, 74%) reported nociceptive pain, which was episodic (64/90, 71%), primarily nocturnal (56/90, 62%), and manifested as cramps (32/90, 36%). PD-related pain was most frequently located in the feet (51/90, 57%), mainly at the toe joints (22/51, 43%). 38/90 (42%) patients with PD pain received analgesic medication with non-steroidal anti-inflammatory drugs being the most frequently used (31/42, 82%) and opioids most effective (70% pain reduction of individual maximum pain intensities, range 22% to 100%, confidence interval 50 to 90%). All patients received oral PD treatment, however, levodopa equivalent dose showed no correlation with mean pain intensities (Spearman´s ? = 0.027, p>0.05).

Conclusions

Our data provide a comprehensive analysis of PD-related pain, giving evidence for mainly non-neuropathic podalgia, which bears the potential to re-think assessment and analgesic treatment of pain in PD in clinical practice.

References

[1] Valkovic P, Minar M, Singliarova H, Harsany J, Hanakova M, Martinkova J,
Benetin J. Pain in Parkinson´ s disease: a cross-sectional study of its
prevalence, types, and relationship to depression and quality of life. PLoS One
2015. 10(8): e0136541.

Presenting Author

Nurcan Üçeyler

Poster Authors

Nurcan Üçeyler, MD

MD

Department of Neurology, University of Würzburg, Germany

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Muscle and Myofascial pain