Motor and autonomic disorders influence on pain syndrome of patients with Parkinson’s disease of the I

Close metadata

OBJECTIVE

To evaluate the influence of motor and autonomic disorders on the pain of patients with PD of the I—III H&Y stages and possibility of correcting the pain with dopamine receptor agonists (ADR).

MATERIAL AND METHODS

252 patients (128 women and 124 men, 42—80 years old) with PD of I—III Hoehn and Yahr stages (H&Y) were examined using the following scales: UPDRS, daily activity Sch&En, quality of life PDQ-39, MMSE, BDI, PFS-16, NMSQuest, GSRS, AUA; 53 patients were piribedil treated during 6 months.

RESULTS

Our results indicated a wide prevalence of pain syndrome in PD patients (58.6%), starting from the early stages (50% for the Ist stage). The most stable pain associations were found with the PD stage, levodopa doses, severity of motor symptoms (postural disorders and hypokinesia manifestations) and motor complications («off-periods» and dyskinesias), as well as non-motor PD manifestations depression and autonomic dysfunctions (constipation, swallowing disorders, and frequent urination). The regression analysis showed, that the severity of motor complications and depression were the predictors of pain occurrence. The pain syndrome in patients with PD of I—III stages underwent significant regression (by 51% and 62%, after 1.5 and 6 months of therapy, respectively) after ADR (piribedil) addition to their therapy; it’s probably due to improving the motor component and decreasing depressive disorders.

CONCLUSIONS

The piribedil inclusion contributes to the reduction of pain syndrome, regardless is it used in monotherapy or in conjunction with levodopa preparations.

Keywords:

Parkinson’s disease

pain

depression

motor complications of PD

dopamine receptor agonists

piribedil

Authors:

Pilipovich A.A.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-7416-9050

Vorobeva O.V.

Chuvash state university named after I.N. Ulyanov

SPIN RSCI: 5084-1379
ORCID: 0000-0003-3259-3691

Received:

11.01.2023

Accepted:

11.01.2023

List of references:

Buhmann C, Wrobel N, Grashorn W, et al. Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy. J Neurol. 2017;264(4):758-769. https://doi.org/10.1007/s00415-017-8426-y
Pilipovich AA. Pain syndrome in case of Parkinson’s disease. Therapy. 2018;7-8(25-26):47-51. (In Russ.). https://doi.org/10.18565/therapy.2018.7-8.47-51
Broen MP, Braaksma MM, Patijn J, Weber WE. Prevalence of pain in Parkinson’s disease: a systematic review using the modified QUADAS tool. Mov Disord. 2012;27(4):480-484. https://doi.org/10.1002/mds.24054
Nègre-Pagès L, Regragui W, Bouhassira D, et al. DoPaMiP Study Group. Chronic pain in Parkinson’s disease: the cross-sectional French DoPaMiP survey. Mov Disord. 2008;23(10):1361-1369. https://doi.org/10.1002/mds.22142
Wasner G, Deuschl G. Pains in Parkinson disease-many syndromes under one umbrella. Nat Rev Neurol. 2012;8(5):284-294. https://doi.org/10.1038/nrneurol.2012.54
Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8:464-474. https://doi.org/10.1016/S1474-4422(09)70068-7
Ford B. Pain in Parkinson’s disease. Mov Disord. 2010;25(suppl 1):98-103. https://doi.org/10.1002/mds.22716
Valkovic P, Minar M, Singliarova H, et al. 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. https://doi.org/10.1371/journal.pone.0136541
Lee MA, Walker RW, Hildreth TJ, Prentice WM. A survey of pain in idiopathic Parkinson’s disease. J Pain Symptom Man. 2006;32(5):462-469. https://doi.org/10.1016/j.jpainsymman.2006.05.020
Defazio G, Berardelli A, Fabbrini G, et al. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol. 2008;65(9):1191-1194. https://doi.org/10.1001/archneurol.2008.2
Beiske AG, Loge JH, Rønningen A, Svensson E. Pain in Parkinson’s disease: Prevalence and characteristics. Pain. 2009;141(1-2):173-177. https://doi.org/10.1016/j.pain.2008.12.004
Zambito MS, Tinazzi M, Vitaliani R, et al. Spontaneous pain, pain threshold, and pain tolerance in Parkinson’s disease. J Neurol. 2011;258(4):627-633. https://doi.org/10.1007/s00415-010-5812-0
Lin XJ, Yu N, Lin XG, et al. A clinical survey of pain in Parkinson’s disease in Eastern China. Int Psychogeriatr. 2016;28(2):283-289. https://doi.org/10.1017/S1041610215001659
Burke AL, Mathias JL, Denson LA. Psychological functioning of people living with chronic pain: a meta-analytic review. Br J Clin Psychol. 2015;3:345-360. https://doi.org/10.1111/bjc.12078
Fil A, Cano-de-la-Cuerda R, Muñoz-Hellín E, et al. Pain in Parkinson disease: a review of the literature. Parkinsonism Relat Disord. 2013;19(3):285-294. https://doi.org/10.1016/j.parkreldis.2012.11.009
Defazio G, Gigante A, Mancino P, Tinazzi M. The epidemiology of pain in Parkinson’s disease. J Neural Transm (Vienna). 2013;120(4):583-586. https://doi.org/10.1007/s00702-012-0915-7
Zhang LM, Chen YQ, Li WJ, et al. Association between mutations of SCN9A gene and pain related to Parkinsonism. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2013;30(1):17-20. https://doi.org/10.3760/cma.j.issn.1003-9406.2013.01.005
Greenbaum L, Tegeder I, Barhum Y, et al. Contribution of genetic variants to pain susceptibility in Parkinson disease. Eur J Pain. 2012;16(9):1243-1250. https://doi.org/10.1002/j.1532-2149.2012.00134.x
Makhnev SO, Levin OS. Clinical variants of pain syndromes in patients with Parkinson’s disease. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2013;113(7-2):39-44. (In Russ.).
Giuffrida R, Vingerhoets FJ, Bogousslavsky J, Ghika J. Syndromes douloureux de la maladie de Parkinson. Rev Neurol (Paris). 2005;161(4):407-418. https://doi.org/10.1016/s0035-3787(05)85070-2
O’Sullivan SS, Williams DR, Gallagher DA, et al. Nonmotor symptoms as presenting complaints in Parkinson’s disease: a clinicopathological study. Mov Disord. 2008;23(1):101-106. https://doi.org/10.1002/mds.21813
Lin CH, Wu RM, Chang HY, et al. Preceding pain symptoms and Parkinson’s disease: a nationwide population-based cohort study. Eur J Neurol. 2013;20(10):1398-1404. https://doi.org/10.1111/ene.12197
Letro GH, Quagliato EM, Viana MA. Pain in Parkinson’s disease. Arq Neuropsiquiatr. 2009;67(3A):591-594. https://doi.org/10.1590/s0004-282x2009000400003
Schestatsky P, Kumru H, Valls-Solé J, et al. Neurophysiologic study of central pain in patients with Parkinson disease. Neurology. 20074;69(23):2162-2169. https://doi.org/10.1212/01.wnl.0000295669.12443.d3
Tison F, Wenning GK, Volonte MA, et al. Pain in multiple system atrophy. J Neurol. 1996;243(2):153-156. https://doi.org/10.1007/BF02444007
Scherder E, Wolters E, Polman C, et al. Pain in Parkinson’s disease and multiple sclerosis: its relation to the medial and lateral pain systems. Neurosci Biobehav Rev. 2005;29(7):1047-1056. https://doi.org/10.1016/j.neubiorev.2005.03.001
Nolano M, Provitera V, Estraneo A, et al. Sensory deficit in Parkinson’s disease: evidence of a cutaneous denervation. Brain. 2008;131(Pt 7):1903-1911. https://doi.org/10.1093/brain/awn102
Juri C, Rodriguez-Oroz M, Obeso JA. The pathophysiological basis of sensory disturbances in Parkinson’s disease. J Neurol Sci. 2010;289(1-2):60-65. https://doi.org/10.1016/j.jns.2009.08.018
Brefel-Courbon C, Payoux P, Thalamas C, et al. Effect of levodopa on pain threshold in Parkinson’s disease: a clinical and positron emission tomography study. Mov Disord. 2005;20(12):1557-1563. https://doi.org/10.1002/mds.20629
Conte A, Khan N, Defazio G, et al. Pathophysiology of somatosensory abnormalities in Parkinson disease. Nat Rev Neurol. 2013;9(12):687-697. https://doi.org/10.1038/nrneurol.2013.224
Gerdelat-Mas A, Simonetta-Moreau M, Thalamas C, et al. Levodopa raises objective pain threshold in Parkinson’s disease: a RIII reflex study. J Neurol Neurosurg Psychiatry. 2007;78(10):1140-1142. https://doi.org/10.1136/jnnp.2007.120212
Nebe A, Ebersbach G. Pain intensity on and off levodopa in patients with Parkinson’s disease. Mov Disord. 2009;24(8):1233-1237. https://doi.org/10.1002/mds.22546
Trenkwalder C, Kies B, Rudzinska M, et al. Recover Study Group. Rotigotine effects on early morning motor function and sleep in Parkinson’s disease: a double-blind, randomized, placebo-controlled study (RECOVER). Mov Disord. 2011;26(1):90-99. https://doi.org/10.1002/mds.23441
Rascol O, Zesiewicz T, Chaudhuri KR, et al. A Randomized Controlled Exploratory Pilot Study to Evaluate the Effect of Rotigotine Transdermal Patch on Parkinson’s Disease-Associated Chronic Pain. J Clin Pharmacol. 2016;56(7):852-861. https://doi.org/10.1002/jcph.678
Buhmann C, Kassubek J, Jost WH. Management of Pain in Parkinson’s Disease. J Parkinsons Dis. 2020;10(s1):37-48. https://doi.org/10.3233/JPD-202069
Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1988;51(6):745-752. https://doi.org/10.1136/jnnp.51.6.745
Jenkinson C, Fitzpatrick R, Peto V, et al. The Parkinson’s Disease Questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing. 1997;26(5):353-357. https://doi.org/10.1093/ageing/26.5.353
Hagell P, Nygren C. The 39 item Parkinson’s disease questionnaire (PDQ-39) revisited: implications for evidence based medicine. J Neurol Neurosurg Psychiatr. 2007;78(11):1191-1198. https://doi.org/10.1136/jnnp.2006.111161
Chaudhuri KR, Martinez-Martin P, Schapira AH, et al. International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: the NMSQuest study. Mov Disord. 2006;21(7):916-923. https://doi.org/10.1002/mds.20844
Brown RG, Dittner A, Findley L, Wessely SC. The Parkinson fatigue scale. Park Relat Disord. 2005;11(1):49-55. https://doi.org/10.1016/j.parkreldis.2004.07.007
Kulich KR, Madisch A, Pacini F, et al. Reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: a six-country study. Health Qual Life Outcomes. 2008;6:12. https://doi.org/10.1186/1477-7525-6-12
Dimenäs E, Carlsson G, Glise H, et al. Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease. Scand J Gastroenterol Suppl. 1996;221:8-13. https://doi.org/10.3109/00365529609095544
Novik AA, Ionova TI. Rukovodstvo po issledovaniyu kachestva zhizni v meditsine. M.: OLMA Media Grupp; 2007. (In Russ.).
O’Leary MP, Barry MJ, Fowler FJ Jr. Hard measures of subjective outcomes: validating symptom indexes in urology. J Urol. 1992;148(5):1546-1548. https://doi.org/10.1016/s0022-5347(17)36965-3
Bolezni predstatel’noi zhelezy. Pod red. Alyaeva Yu.G. M.: GEOTAR-Media; 2009. (In Russ.).
Lemack GE, Dewey RB Jr, Roehrborn CG, et al. Questionnaire-based assessment of bladder dysfunction in patients with mild to moderate Parkinson’s disease. Urology. 2000;56(2):250-254. https://doi.org/10.1016/s0090-4295(00)00641-5
Silverdale MA, Kobylecki C, Kass-Iliyya L, et al. UK Parkinson’s Pain Study Collaboration. A detailed clinical study of pain in 1957 participants with early/moderate Parkinson’s disease. Parkinsonism Relat Disord. 2018;56:27-32. https://doi.org/10.1016/j.parkreldis.2018.06.001
Barone P, Antonini A, Colosimo C, et al.; PRIAMO study group. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord. 2009;24(11):1641-1649. https://doi.org/10.1002/mds.22643
Rahman S, Griffin HJ, Quinn NP, Jahanshahi M. Quality of life in Parkinson’s disease: the relative importance of the symptoms. Mov Disord. 2008;23:1428-1434. https://doi.org/10.1002/mds.21667
Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord. 2010;25:2493-2500. https://doi.org/10.1002/mds.23394
Martinez-Martin P, Rojo-Abuin MJ, Rizos A, et al. The IPMDS Non Motor PD Study Group Distribution and impact on quality of life of the pain modalities assessed by the King’s Parkinson’s disease pain scale. NPJ Park Dis. 2017;3:8. https://doi.org/10.1038/s41531-017-0009-1
Tinazzi M, Del Vesco C, Fincati E, et al. Pain and motor complications in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2006;77(7):822-825. https://doi.org/10.1136/jnnp.2005.079053
Pilipovich AA, Golubev VL. The agonist of dopamine receptors piribedil in treatment of Parkinson’s disease. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2017;117(6):83-90. (In Russ.). https://doi.org/10.17116/jnevro20171176183-90
Barone P, Poewe W, Albrecht S, et al. Pramipexole for the treatment of depressive symptoms in patients with Parkinson’s disease: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2010;9(6):573-580. https://doi.org/10.1016/S1474-4422(10)70106-X

Close metadata