Pain in Parkinson disease: a deep phenotyping study

Area of Science:

• Neurology
• Pain Medicine
• Clinical Research

Background:

• Parkinson disease (PD) frequently involves non-motor symptoms, including pain, impacting patient quality of life.
• Characterizing PD-related pain is crucial for effective management strategies.
• Previous studies have varied in their focus and patient populations.

Purpose of the Study:

• To comprehensively characterize Parkinson disease-related pain in a monocentrically recruited patient cohort.
• To compare pain characteristics between patients with and without PD-related pain.
• To evaluate the effectiveness of different analgesic medications in PD patients.

Main Methods:

• Prospective cross-sectional study involving 150 patients with Parkinson disease.
• Systematic interviews and validated questionnaires for pain, depression, motor, and non-motor symptoms.
• Categorization of patients into PD-related pain, no PD-related pain, and no pain groups.

Main Results:

• 72% of PD patients reported pain; 60% were classified as having PD-related pain.
• Nociceptive pain (74%) was common, often episodic (71%), nocturnal (62%), presenting as cramps (36%), and located in the feet (57%).
• Opioids demonstrated the highest effectiveness (70% pain reduction), while levodopa equivalent dose showed no correlation with pain intensity.

Conclusions:

• Parkinson disease-related pain is prevalent and often non-neuropathic, particularly podalgia (foot pain).
• Current analgesic strategies, especially opioid use, show potential for effective pain management.
• Findings suggest a need to reassess pain assessment and treatment protocols in clinical practice for Parkinson disease.