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A detailed clinical study of pain in 1957 participants with early/moderate Parkinson's disease

Silverdale, MA; Kobylecki, C; Kass-Iliyya, L; Martinez-Martin, P; Lawton, M; Cotterill, S; Chaudhuri, KR; ... Grosset, DG; + view all (2018) A detailed clinical study of pain in 1957 participants with early/moderate Parkinson's disease. Parkinsonism & Related Disorders , 56 pp. 27-32. 10.1016/j.parkreldis.2018.06.001. Green open access

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Abstract

INTRODUCTION: The causes of pain in early/moderate Parkinson's disease (PD) are not well understood. Although peripheral factors such as rigidity, reduced joint movements and poor posture may contribute towards the development of pain, central mechanisms including altered nociceptive processing may also be involved. METHODS: We performed a large clinical study to investigate potential factors contributing towards pain in early/moderate PD. We recruited 1957 PD participants who had detailed assessments of pain, motor and non-motor symptoms. The King's Parkinson's Pain scale was used to quantify different subtypes of pain. RESULTS: 85% of participants reported pain (42% with moderate to severe pain). Pain influenced quality of life more than motor symptoms in a multiple regression model. Factors predicting overall pain severity included affective symptoms, autonomic symptoms, motor complications, female gender and younger age, but not motor impairment or disease duration. There was negligible correlation between the severity of motor impairment and the severity of musculoskeletal or dystonic pain as well as between the severity of OFF period motor problems and the severity of OFF period pain or OFF period dystonic pain. Features of central sensitization, including allodynia and altered pain sensation were common in this population. The use of drugs targeting central pain was very low. CONCLUSIONS: Pain in early/moderate PD cannot be explained by peripheral factors. Central causes may play a much more important role than previously considered. These results should lead to a major shift in the investigation and management of this common and disabling symptom.

Type: Article
Title: A detailed clinical study of pain in 1957 participants with early/moderate Parkinson's disease
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.parkreldis.2018.06.001
Publisher version: https://doi.org/10.1016/j.parkreldis.2018.06.001
Language: English
Additional information: © 2018 The Authors. Published by Elsevier Ltd. This is an Open Access article distributed under the terms of the Creative Commons license (https://creativecommons.org/licenses/by/4.0/).
Keywords: Pain, Parkinson's disease, Nonmotor, Central sensitization, Musculoskeletal
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10053865
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