Chronic subthalamic deep brain stimulation improves pain in Parkinson disease.
Kim HJ, Paek SH, Kim JY, Lee JY, Lim YH, Kim MR, Kim DG, Jeon BS. Chronic subthalamic deep brain stimulation improves pain in Parkinson disease. , Dec; 255(12):1889-94. Epub 2009 Jan 22
The purpose of this article was to look at pain in a subset of PWP before and after DBS STN. The article cites a prevalence rate of “40-78%” of the general group of PWP experiencing pain. Approximately 80% of the PWP in this study reported pain in multiple areas of the body preoperatively. The majority of the patients reported here had bilateral STN but a few had unilateral STN for specific reasons mentioned in the article. Three months after surgery, the majority of those patients that were experiencing pain endorsed improvement (87%) in regard to their pain. The authors found that dystonic pain was the most improved and back pain was the least reduced of the pain complaints. It should be noted that not all patients had improvement in their pain and other patients developed pain where none existed prior to the DBS STN (24%). After 6 months, most of the patients that had experienced a reduction in pain continued to report such reduction. The authors also postulated ideas why DBS STN would reduce pain including reduced muscle tone, possible basal ganglia involvement, and other neuroanatomical possibilities. More research needs to be done on pain in PWP to better understand how a treatment option for improved motor control may also be beneficial in reduction in yet another non-motor symptom of PD. The authors also suggest that pain and DBS STN needs to be looked at longitudinally versus at a single point in time to best represent pain control or reduction in this group of people.