Chronic pain in Parkinson’s disease: the cross-sectional French DoPaMiP survey.
Nègre-Pagès L, Regragui W, Bouhassira D, Grandjean H, Rascol O; DoPaMiP Study Group Chronic pain in Parkinson’s disease: the cross-sectional French DoPaMiP survey. , 2008 Jul 30; 23(10):1361-9
This article looked at chronic pain in Parkinson’s disease. It should be noted that the patients involved did not have DBS. The authors defined pain in two ways, 1. Pain related to PD and 2. Pain not related to PD. Also, chronic pain has been defined by the International Association for the Study of Pain (IASP) as having unpleasant sensory and emotional experiences with actual or potential tissue damage that lasts for more than 3 months. Pain was assessed by various questionnaires as was depression, sleep quality, and quality of life in patients with PD as compared to a medical group without PD. The authors found that the PD group had more severe depression, anxiety, and sleep disturbances than the medical group without PD. Sixty-one percent of the PD patients met the criteria for chronic pain compared to 58.2% of the medical group. However, when they “controlled for”/ took into account osteoarthritis in both groups (which is a common cause of pain for the general public), the PD group was twice as likely to suffer from chronic pain as the medical group. Of the PWP and chronic pain, about 60% had pain due to their PD (aggravated osteoarthritis, dystonia, neuropathic pain, akathisia, which is a sense of discomfort or restlessness, and “deep ache, myalgia, cramps, stiffness, or discomfort”).
This research also found that PWP having chronic pain due to their PD tended to be younger, have an earlier onset of PD, tend not to use analgesic medications for pain, and had a more severe case of PD on multiple medical measures than the other groups. Additionally, PWP with chronic pain related to PD reported lower quality of life when compared to PD patients without pain or those with pain not related to their PD. The authors stated that pain appears to be another component of PD because the group with chronic pain due to PD was noticeably different than the group with chronic pain that is not attributable to PD. The authors also discussed possible neurotransmitters that may be involved in pain related to PD. Thus, it is evident that pain is a part of the PD experience, but it continues to be under recognized and understudied in this population. The understanding of pain deserves more attention and research for the PD population as a whole as well as for the PD patient with DBS to improve treatment of this disease and to improve the quality.
(The full article was available free online at the time of this writing through the pubmed link below. Click on the red MDS button at the bottom of the abstract. This should take you to the Movement Disorder Society website and you can click on the PDF or HTML option. This appears to be a monthly special review of this article, which suggests it may not be available indefinitely.)