A Dual Centre Study of Pain in Parkinson's Disease and Its Relationship with Other Non-Motor Symptoms

Pritha Ghosh; Paola Imbriani; Nicoletta Caputi; Silvia Natoli; Tommaso Schirinzi; Giulia DI Lazzaro; Lindsey Covington; Andrew D. Sparks; Yekaterina Salnikova; Katarina Rukavina; K. Ray Chaudhuri; Antonio Pisani

doi:10.3233/JPD-202088

A Dual Centre Study of Pain in Parkinson's Disease and Its Relationship with Other Non-Motor Symptoms

Pritha Ghosh, Paola Imbriani, Nicoletta Caputi, Silvia Natoli, Tommaso Schirinzi, Giulia DI Lazzaro, Lindsey Covington, Andrew D. Sparks, Yekaterina Salnikova, Katarina Rukavina, K. Ray Chaudhuri, Antonio Pisani^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

26 Citations (Scopus)

Abstract

Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson's disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (HY) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman's rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and HY stage >2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways.

Original language	English
Pages (from-to)	1817-1825
Number of pages	9
Journal	Journal of Parkinson's Disease
Volume	10
Issue number	4
DOIs	https://doi.org/10.3233/JPD-202088
Publication status	Published - 2020

Keywords

Neurodegeneration
noradrenergic pathway
pain
parkinsonism
serotonergic pathway

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10.3233/JPD-202088

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@article{aaeccc82775742d086045be4cb57bca1,

title = "A Dual Centre Study of Pain in Parkinson's Disease and Its Relationship with Other Non-Motor Symptoms",

abstract = "Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson's disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (HY) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman's rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and HY stage >2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways. ",

keywords = "Neurodegeneration, noradrenergic pathway, pain, parkinsonism, serotonergic pathway",

author = "Pritha Ghosh and Paola Imbriani and Nicoletta Caputi and Silvia Natoli and Tommaso Schirinzi and {DI Lazzaro}, Giulia and Lindsey Covington and Sparks, {Andrew D.} and Yekaterina Salnikova and Katarina Rukavina and {Ray Chaudhuri}, K. and Antonio Pisani",

year = "2020",

doi = "10.3233/JPD-202088",

language = "English",

volume = "10",

pages = "1817--1825",

journal = "Journal of Parkinson's Disease",

issn = "1877-7171",

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number = "4",

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TY - JOUR

T1 - A Dual Centre Study of Pain in Parkinson's Disease and Its Relationship with Other Non-Motor Symptoms

AU - Ghosh, Pritha

AU - Imbriani, Paola

AU - Caputi, Nicoletta

AU - Natoli, Silvia

AU - Schirinzi, Tommaso

AU - DI Lazzaro, Giulia

AU - Covington, Lindsey

AU - Sparks, Andrew D.

AU - Salnikova, Yekaterina

AU - Rukavina, Katarina

AU - Ray Chaudhuri, K.

AU - Pisani, Antonio

PY - 2020

Y1 - 2020

N2 - Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson's disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (HY) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman's rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and HY stage >2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways.

AB - Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson's disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (HY) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman's rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and HY stage >2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways.

KW - Neurodegeneration

KW - noradrenergic pathway

KW - pain

KW - parkinsonism

KW - serotonergic pathway

UR - http://www.scopus.com/inward/record.url?scp=85095461918&partnerID=8YFLogxK

U2 - 10.3233/JPD-202088

DO - 10.3233/JPD-202088

M3 - Article

C2 - 33016892

AN - SCOPUS:85095461918

SN - 1877-7171

VL - 10

SP - 1817

EP - 1825

JO - Journal of Parkinson's Disease

JF - Journal of Parkinson's Disease

IS - 4

ER -

A Dual Centre Study of Pain in Parkinson's Disease and Its Relationship with Other Non-Motor Symptoms

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