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Lei J, Tang LL, You HJ. Pathological pain: Non-motor manifestations in Parkinson disease and its treatment. Neurosci Biobehav Rev 2024; 161:105646. [PMID: 38569983 DOI: 10.1016/j.neubiorev.2024.105646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
In addition to motor symptoms, non-motor manifestations of Parkinson's disease (PD), i.e. pain, depression, sleep disturbance, and autonomic disorders, have received increasing attention. As one of the non-motor symptoms, pain has a high prevalence and is considered an early pre-motor symptom in the development of PD. In relation to pathological pain and its management in PD, particularly in the early stages, it is hypothesized that the loss of dopaminergic neurons causes a functional deficit in supraspinal structures, leading to an imbalance in endogenous descending modulation. Deficits in dopaminergic-dependent pathways also affect non-dopaminergic neurotransmitter systems that contribute to the pathological processing of nociceptive input, the integration, and modulation of pain in PD. This review examines the onset and progression of pain in PD, with a particular focus on alterations in the central modulation of nociception. The discussion highlights the importance of abnormal endogenous descending facilitation and inhibition in PD pain, which may provide potential clues to a better understanding of the nature of pathological pain and its effective clinical management.
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Affiliation(s)
- Jing Lei
- Center for Translational Medicine Research on Sensory-Motor Diseases, Yan'an University, Yan'an 716000, China; Key Laboratory of Yan'an Sports Rehabilitation Medicine, Yan'an 716000, China
| | - Lin-Lin Tang
- Center for Translational Medicine Research on Sensory-Motor Diseases, Yan'an University, Yan'an 716000, China
| | - Hao-Jun You
- Center for Translational Medicine Research on Sensory-Motor Diseases, Yan'an University, Yan'an 716000, China; Key Laboratory of Yan'an Sports Rehabilitation Medicine, Yan'an 716000, China.
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2
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Ghilardi MGS, Campos ACP, Cury RG, Martinez RCR, Pagano RL, Fonoff ET. Efficacy of deep brain stimulation of the subthalamic nucleus versus globus pallidus internus on sensory complaints. NPJ Parkinsons Dis 2024; 10:73. [PMID: 38553493 PMCID: PMC10980743 DOI: 10.1038/s41531-024-00689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
Pain control after deep brain stimulation (DBS) in Parkinson's disease (PD) remains unclear. Following six months, subthalamic (STN)-DBS reduced sensory complaints related to parkinsonism and bodily discomfort, increasing central beta-endorphin level. Pallidal GPi-DBS decreased bodily discomfort and beta-endorphin levels. Unexplained pain by other conditions and bodily discomfort were negatively correlated with beta-endorphin levels. Thus, DBS regulates central opioids, and prioritizing STN is important for PD patients with significant sensory complications.
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Affiliation(s)
- Maria Gabriela S Ghilardi
- Division of Functional Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | | | - Rubens G Cury
- Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Raquel C R Martinez
- Laboratory of Neuroscience, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
- LIM/23, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Rosana L Pagano
- Laboratory of Neuroscience, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil.
| | - Erich T Fonoff
- Division of Functional Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
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3
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Abilashimova D, Aubakirova M, Abdildin Y, Viderman D. Safinamide for pain management in patients with Parkinson's disease. Rev Neurol (Paris) 2023:S0035-3787(23)01143-8. [PMID: 38103994 DOI: 10.1016/j.neurol.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/16/2023] [Accepted: 10/12/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Pain is often neglected in Parkinson's disease (PD), although it impacts most PD patients. While the mechanism of pain in PD is still being studied, various pharmacological, interventional, and alternative treatment options have been offered for pain relief. Safinamide, a recently approved drug for PD, has shown promising results in improving pain in patients with PD. Several clinical studies report changes in pain scores in PD patients treated with safinamide, but these have not been systematically summarized. Therefore, our main goal was to perform a systematic review and statistical analysis of relevant studies. METHODS A systematic search of studies was conducted using four databases: Pubmed, Cochrane Library, Google Scholar, and Scopus. The nine included randomized controlled trials did not provide sufficient data for a meta-analysis; therefore, we conducted a qualitative systematic review. RESULTS Our results suggest that safinamide at a daily dose of 100mg is more effective for treating PD pain than that of 50mg. Moreover, the reduction in fluctuation-related pain and pain from edema was more consistent when treated with safinamide compared to other PD pain types. We also attempted to suggest a mechanism of action for safinamide on pain processing in the brain, which should be explored in more detail in future studies. CONCLUSION Clinical evidence suggests that safinamide may be particularly beneficial for PD patients experiencing fluctuation-related pain and pain from edema, as these subtypes of pain showed greater improvement compared to other types of pain. Based on the findings of the included studies, safinamide appears to relieve the overall pain burden. However, the lack of sufficient data for conducting a meta-analysis highlights the need for future studies to report mean pain scores and their standard deviations.
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Affiliation(s)
- D Abilashimova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kerei, Zhanibek khandar street 5/1, Astana 020000, Kazakhstan
| | - M Aubakirova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kerei, Zhanibek khandar street 5/1, Astana 020000, Kazakhstan
| | - Y Abdildin
- School of Engineering and Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
| | - D Viderman
- Department of Surgery, School of Medicine, Nazarbayev University, Kerei and Zhanibek khandar street 5/1, Astana 020000, Kazakhstan; Department of Anesthesiology, Intensive Care, and Pain Medicine, National Research Oncology Center, Kerei and Zhanibek khandar street 5/1, Astana 020000, Kazakhstan.
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Shaheen N, Shaheen A, Elgendy A, Bezchlibnyk YB, Zesiewicz T, Dalm B, Jain J, Green AL, Aziz TZ, Flouty O. Deep brain stimulation for chronic pain: a systematic review and meta-analysis. Front Hum Neurosci 2023; 17:1297894. [PMID: 38098761 PMCID: PMC10719838 DOI: 10.3389/fnhum.2023.1297894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Background Deep brain stimulation (DBS) has shown promise in effectively treating chronic pain. This study aimed to assess the efficacy of DBS in this context. Methods We conducted a systematic literature search using PubMed, Scopus, and Web of Science, following the PRISMA guidelines. A well-constructed search strategy was utilized. Our literature search identified two groups of subjects: one group underwent DBS specifically for chronic pain treatment (DBS-P), while the second group received DBS for other indications (DBS-O), such as Parkinson's disease or dystonia, with pain perception investigated as a secondary outcome in this population. Meta-analysis was performed using R version 4.2.3 software. Heterogeneity was assessed using the tau^2 and I^2 indices, and Cochran's Q-test was conducted. Results The analysis included 966 patients in 43 original research studies with chronic pain who underwent DBS (340 for DBS-P and 625 for DBS-O). Subgroup analysis revealed that DBS-P exhibited a significant effect on chronic pain relief, with a standardized mean difference (SMD) of 1.65 and a 95% confidence interval (CI) of [1.31; 2.00]. Significant heterogeneity was observed among the studies, with an I^2 value of 85.8%. However, no significant difference was found between DBS-P and DBS-O subgroups. Subgroup analyses based on study design, age, pain diseases, and brain targets demonstrated varying levels of evidence for the effectiveness of DBS across different subgroups. Additionally, meta-regression analyses showed no significant relationship between age or pain duration and DBS effectiveness for chronic pain. Conclusion These findings significantly contribute to the expanding body of knowledge regarding the utility of DBS in the management of chronic pain. The study underscores the importance of conducting further research to enhance treatment outcomes and elucidate patient-specific factors that are associated with treatment response. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=428442, identifier CRD42023428442.
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Affiliation(s)
- Nour Shaheen
- Alexandria Faculty of Medicine, Alexandria, Egypt
| | | | | | - Yarema B. Bezchlibnyk
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States
| | - Theresa Zesiewicz
- Department of Neurology, University of South Florida, Tampa, FL, United States
| | - Brian Dalm
- Department of Neurosurgery, The Ohio State University, Columbus, OH, United States
| | - Jennifer Jain
- Department of Neurology, University of South Florida, Tampa, FL, United States
| | - Alexander L. Green
- Oxford Functional Neurosurgery, Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Tipu Z. Aziz
- Oxford Functional Neurosurgery, Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Oliver Flouty
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States
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5
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Lan X, Niu X, Bai WX, Li HN, Zhu XY, Ma WJ, Li JL, Dun WH, Zhang M, He J. The functional connectivity of the basal ganglia subregions changed in mid-aged and young males with chronic prostatitis/chronic pelvic pain syndrome. Front Hum Neurosci 2022; 16:1013425. [PMID: 36248695 PMCID: PMC9563619 DOI: 10.3389/fnhum.2022.1013425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background The Basal ganglia (BG) played a crucial role in the brain-level mechanisms of chronic pain disorders. However, the functional changes of BG in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are still poorly understood. This study investigated the BG subregions’ resting-state functional connectivity (rs-FC) in CP/CPPS patients compared with healthy controls. Methods Twenty eight patients with CP/CPPS and 28 age- and education-matched healthy males underwent clinical measurements and 3T brain MR imaging, including T1-weighted structural images and resting-state functional imaging. The data were analyzed by the seeded-based rs-FC analysis. Then, a machine learning method was applied to assess the feasibility of detecting CP/CPPS patients through the changed rs-FC. Results Compared with healthy males, patients presented decreased rs-FC between the BG subregions and right middle cingulate cortex, and correlated with pain (r = 0.51, p-uncorrected = 0.005) and urinary symptoms (r = –0.4, p-uncorrected = 0.034). The left superior temporal gyrus and right supramarginal gyrus showed decreased rs-FC with the BG subregions as well. The area under the receiver operating characteristic curve of 0.943 (accuracy = 80%, F1-score = 80.6%) was achieved for the classification of CP/CPPS patients and healthy males with support vector machine (SVM) based on the changed rs-FC. Conclusion These findings provide evidence of altered BG subregions’ rs-FC in CP/CPPS, which may contribute to our understanding of the BG’s role in CP/CPPS.
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Affiliation(s)
- Xi Lan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xuan Niu
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei-Xian Bai
- Department of Medical Imaging, Xi’an No.3 Hospital, Xi’an, China
| | - Hai-Ning Li
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xin-Yi Zhu
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wen-Jun Ma
- Department of Urology, Xi’an No.3 Hospital, Xi’an, China
| | - Jian-Long Li
- Department of Urology, Xi’an No.3 Hospital, Xi’an, China
| | - Wang-Huan Dun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ming Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Ming Zhang,
| | - Juan He
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Juan He,
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Flouty O, Yamamoto K, Germann J, Harmsen IE, Jung HH, Cheyuo C, Zemmar A, Milano V, Sarica C, Lozano AM. Idiopathic Parkinson's disease and chronic pain in the era of deep brain stimulation: a systematic review and meta-analysis. J Neurosurg 2022; 137:1821-1830. [PMID: 35535836 DOI: 10.3171/2022.2.jns212561] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Pain is the most common nonmotor symptom of Parkinson's disease (PD) and is often undertreated. Deep brain stimulation (DBS) effectively mitigates the motor symptoms of this multisystem neurodegenerative disease; however, its therapeutic effect on nonmotor symptoms, especially pain, remains inconclusive. While there is a critical need to help this large PD patient population, guidelines for managing this significant disease burden are absent. Herein, the authors systematically reviewed the literature and conducted a meta-analysis to study the influence of traditional (subthalamic nucleus [STN] and globus pallidus internus [GPi]) DBS on chronic pain in patients with PD. METHODS The authors performed a systematic review of the literature and a meta-analysis following PRISMA guidelines. Risk of bias was assessed using the levels of evidence established by the Oxford Centre for Evidence-Based Medicine. Inclusion criteria were articles written in English, published in a peer-reviewed scholarly journal, and about studies conducting an intervention for PD-related pain in no fewer than 5 subjects. RESULTS Twenty-six studies were identified and included in this meta-analysis. Significant interstudy heterogeneity was detected (Cochran's Q test p < 0.05), supporting the use of the random-effects model. The random-effects model estimated the effect size of DBS for the treatment of idiopathic pain as 1.31 (95% CI 0.84-1.79). The DBS-on intervention improved pain scores by 40% as compared to the control state (preoperative baseline or DBS off). CONCLUSIONS The results indicated that traditional STN and GPi DBS can have a favorable impact on pain control and improve pain scores by 40% from baseline in PD patients experiencing chronic pain. Further trials are needed to identify the subtype of PD patients whose pain benefits from DBS and to identify the mechanisms by which DBS improves pain in PD patients.
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Affiliation(s)
- Oliver Flouty
- 1Department of Neurosurgery, University of South Florida, Tampa, Florida
| | - Kazuaki Yamamoto
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jurgen Germann
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Irene E Harmsen
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hyun Ho Jung
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,3Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Cletus Cheyuo
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Zemmar
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,4Department of Neurosurgery, University of Louisville, School of Medicine, Louisville, Kentucky; and.,5Department of Neurosurgery, Henan Provincial People's Hospital, Henan University People's Hospital, Henan University School of Medicine, Zhengzhou, China
| | - Vanessa Milano
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Can Sarica
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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7
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Yamamoto K, Elias GJB, Beyn ME, Zemmar A, Loh A, Sarica C, Germann J, Parmar R, Wong EHY, Boutet A, Kalia S, Hodaie M, Lozano AM. Neuromodulation for Pain: A Comprehensive Survey and Systematic Review of Clinical Trials and Connectomic Analysis of Brain Targets. Stereotact Funct Neurosurg 2021; 100:14-25. [PMID: 34380132 DOI: 10.1159/000517873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic pain is a debilitating condition that imposes a tremendous burden on health-care systems around the world. While frontline treatments for chronic pain involve pharmacological and psychological approaches, neuromodulation can be considered for treatment-resistant cases. Neuromodulatory approaches for pain are diverse in both modality and target and their mechanism of action is incompletely understood. OBJECTIVES The objectives of this study were to (i) understand the current landscape of pain neuromodulation research through a comprehensive survey of past and current registered clinical trials (ii) investigate the network underpinnings of these neuromodulatory treatments by performing a connectomic mapping analysis of cortical and subcortical brain targets that have been stimulated for pain relief. METHODS A search for clinical trials involving pain neuromodulation was conducted using 2 major trial databases (ClinicalTrials.gov and the International Clinical Trials Registry Platform). Trials were categorized by variables and analyzed to gain an overview of the contemporary research landscape. Additionally, a connectomic mapping analysis was performed to investigate the network connectivity patterns of analgesic brain stimulation targets using a normative connectome based on a functional magnetic resonance imaging dataset. RESULTS In total, 487 relevant clinical trials were identified. Noninvasive cortical stimulation and spinal cord stimulation trials represented 49.3 and 43.7% of this count, respectively, while deep brain stimulation trials accounted for <3%. The mapping analysis revealed that superficial target connectomics overlapped with deep target connectomics, suggesting a common pain network across the targets. CONCLUSIONS Research for pain neuromodulation is a rapidly growing field. Our connectomic network analysis reinforced existing knowledge of the pain matrix, identifying both well-described hubs and more obscure structures. Further studies are needed to decode the circuits underlying pain relief and determine the most effective targets for neuromodulatory treatment.
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Affiliation(s)
- Kazuaki Yamamoto
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada,
| | - Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Michelle E Beyn
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Zemmar
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Department of Neurosurgery, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University People's Hospital, Henan University School of Medicine, Zhengzhou, China
| | - Aaron Loh
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Can Sarica
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Roohie Parmar
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Emily H Y Wong
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Suneil Kalia
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Mojgan Hodaie
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Diao Y, Bai Y, Hu T, Yin Z, Liu H, Meng F, Yang A, Zhang J. A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain. Front Hum Neurosci 2021; 15:688818. [PMID: 34276330 PMCID: PMC8281028 DOI: 10.3389/fnhum.2021.688818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
Pain from Parkinson's disease (PD) is a non-motor symptom affecting the quality of life and has prevalence of 20–80%. However, it is unclear whether subthalamic nucleus deep brain stimulation (STN–DBS), a well-established treatment for PD, is effective forPD-related pain. Thus, the objective of this meta-analysis was to investigate the efficacy of STN-DBS on PD-related pain and explore how its duration affects the efficacy of STN-DBS. A systematic search was performed using PubMed, Embase, and the Cochrane Library. Nine studies included numerical rating scale (NRS), visual analog scale (VAS), or non-motor symptom scale (NMSS) scores at baseline and at the last follow-up visit and therefore met the inclusion criteria of the authors. These studies exhibited moderate- to high-quality evidence. Two reviewers conducted assessments for study eligibility, risk of bias, data extraction, and quality of evidence rating. Random effect meta-analysis revealed a significant change in PD-related pain as assessed by NMSS, NRS, and VAS (P <0.01). Analysis of the short and long follow-up subgroups indicated delayed improvement in PD-related pain. These findings (a) show the efficacy of STN-DBS on PD-related pain and provide higher-level evidence, and (b) implicate delayed improvement in PD-related pain, which may help programming doctors with supplement selecting target and programming. Systematic Review Registration: This study is registered in Open Science Framework (DOI: 10.17605/OSF.IO/DNM6K).
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Affiliation(s)
- Yu Diao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tianqi Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huangguang Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
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9
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Paparella G, Di Stefano G, Fasolino A, Di Pietro G, Colella D, Truini A, Cruccu G, Berardelli A, Bologna M. Painful stimulation increases spontaneous blink rate in healthy subjects. Sci Rep 2020; 10:20014. [PMID: 33203984 PMCID: PMC7672065 DOI: 10.1038/s41598-020-76804-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
Spontaneous blink rate is considered a biomarker of central dopaminergic activity. Recent evidence suggests that the central dopaminergic system plays a role in nociception. In the present study, we aimed to investigate whether pain modulates spontaneous blink rate in healthy subjects. We enrolled 15 participants. Spontaneous blink rate was quantified with an optoelectronic system before and after: (1) a painful laser stimulation, and (2) an acoustic startling stimulation. In control experiments, we investigated whether laser stimulation effects depended on stimulation intensity and whether laser stimulation induced any changes in the blink reflex recovery cycle. Finally, we investigated any relationship between spontaneous blink rate modification and pain modulation effect during the cold pressor test. Laser, but not acoustic, stimulation increased spontaneous blink rate. This effect was independent of stimulation intensity and negatively correlated with pain perception. No changes in trigeminal-facial reflex circuit excitability were elicited by laser stimulation. The cold pressor test also induced an increased spontaneous blink rate. Our study provides evidence on the role of dopamine in nociception and suggests that dopaminergic activity may be involved in pain modulation. These findings lay the groundwork for further investigations in patients with pathological conditions characterized by dopaminergic deficit and pain.
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Affiliation(s)
| | - Giulia Di Stefano
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alessandra Fasolino
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giuseppe Di Pietro
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Donato Colella
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Andrea Truini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, IS, Italy. .,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
| | - Matteo Bologna
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
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