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Diaconu S, Monescu V, Filip R, Marian L, Kakucs C, Murasan I, Chaudhuri KR, Jianu DC, Falup-Pecurariu C, Opritoiu B. The Impact of Fatigue on Sleep and Other Non-Motor Symptoms in Parkinson's Disease. Brain Sci 2024; 14:397. [PMID: 38672046 PMCID: PMC11048391 DOI: 10.3390/brainsci14040397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Fatigue is a common non-motor symptom in Parkinson's disease (PD), but even so, it may still be underdiagnosed or misdiagnosed in current practice due to its non-specific manifestations. The aims of this study were to investigate the prevalence of fatigue in PD patients compared to healthy controls and to identify the main characteristics and associations of fatigue with other non-motor symptoms and the impact of fatigue on sleep disturbances in Parkinson's disease. MATERIALS AND METHODS case-control study in which 131 PD patients and 131 age- and sex-matched controls were enrolled. Main characteristics of fatigue, sleep, and other non-motor symptoms were assessed using specific validated questionnaires. RESULTS According to the Chalder fatigue scale, fatigue is more prevalent in PD patients (38.16%) compared to healthy controls (26.71%). Fatigue was identified in 46.54% of the PD patients using the Parkinson's Fatigue Scale (PFS-16). PD patients with fatigue presented a worse motor status, more sleep disturbances (insomnia, daytime sleepiness), a broader spectrum of non-motor symptoms (pain, anxiety, urinary disturbances), worse cognitive performances, a lower level of happiness, and worse quality of life compared to PD patients without fatigue. CONCLUSION Fatigue is a common symptom of PD and needs to be assessed, considering its consequences on quality of life. Sleep disturbances have a great influence over fatigue in PD patients.
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Affiliation(s)
- Stefania Diaconu
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Vlad Monescu
- Faculty of Mathematics and Informatics, Transilvania University, 500036 Brașov, Romania
| | - Rafaela Filip
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Laura Marian
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Cristian Kakucs
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Iulia Murasan
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
| | - K. Ray Chaudhuri
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK;
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Dragos Catalin Jianu
- Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- “Pius Branzeu” Clinical Emergency County Hospital, 300736 Timisoara, Romania
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Bianca Opritoiu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
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Alissa N, Khalil H, Kanaan S, Aldughmi M, Al-Sharman A, Morris L, Latrous MS, El-Salem K. Translation, cultural adaptation and validation of the Arabic version of the king's Parkinson's disease pain scale. Disabil Rehabil 2024; 46:1615-1620. [PMID: 37161828 DOI: 10.1080/09638288.2023.2202416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 04/08/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Pain in Parkinson's disease (PD) is a highly prevalent non-motor symptom occurring in this population. The King's PD Pain Scale (KPPS) was developed to assess pain in people with PD. This study aimed to provide a cross-cultural adaptation and translation of the KPPS into the Arabic language (A-KPPS), and to investigate the construct and convergent validity, internal consistency, and reliability of the translated scale. MATERIALS AND METHODS The English KPPS was translated into Arabic and back-translated into English by an independent translation team. The Arabic version was tested in 103 native Arabic speaking PD patients. We assessed construct validity, convergent validity, and test-retest reliability of the A-KPPS using factor analysis method, comparison with other valid and reliable measures, and using intra-class correlations, respectively. RESULTS The A-KPPS had three main factors "somatic pain", "visceral and burning pain" and "orofacial pain", rather than the original four factors scale. The A-KPPS correlated with measures of disease motor severity, depression, anxiety, quality of life and pain (p < 0.05). Furthermore, the A-KPPS total score had high test-retest reliability (ICC = 0.9). CONCLUSIONS The A-KPPS demonstrated moderate to good validity and reliability. The A-KPPS can facilitate the assessment and treatment of pain in Arabic-speaking people with PD worldwide.
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Affiliation(s)
- Nesreen Alissa
- Department of Physical Therapy and Rehabilitation Science, University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | - Hanan Khalil
- Department of Physical Therapy and Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Saddam Kanaan
- Department of Physical Therapy and Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mayis Aldughmi
- Department of Physiotherapy, The University of Jordan, School of Rehabilitation Sciences, Amman, Jordan
| | - Alham Al-Sharman
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Linzette Morris
- Department of Physical Therapy and Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mariem Sirine Latrous
- Department of Physical Therapy and Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Khalid El-Salem
- Faculty of Medicine, Department of Neurosciences, Jordan University of Science and Technology, Irbid, Jordan
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Conte L, Lupo R, Lezzi P, Pedone A, Rubbi I, Lezzi A, Vitale E, Fasano A, De Nunzio G. Statistical analysis and generative Artificial Intelligence (AI) for assessing pain experience, pain-induced disability, and quality of life in Parkinson's disease patients. Brain Res Bull 2024; 208:110893. [PMID: 38316194 DOI: 10.1016/j.brainresbull.2024.110893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
The Parkinson's Disease (PD) is a chronic neurodegenerative condition characterized by motor symptoms such as tremors, rigidity, and bradykinesia, which can significantly impact various aspects of daily life. Among these aspects, pain is a prominent element. Despite the widespread use of therapies aimed at improving symptoms and quality of life, effective pain management is essential to enhance the quality of life of individuals affected by this disease. However, a detailed understanding of the factors associated with pain in PD is still evolving. In this study, we examined the disability caused by pain and the pain experienced by PD patients using two validated questionnaires, namely the Parkinson's Disease Questionnaire (PDQ) and the King's Parkinson's Disease Pain Questionnaire (KPPQ). Customized questions were also included to further explore the pain experience and management strategies adopted by PD patients. Through statistical analysis, we explored the relationships between questionnaire scores, socio-demographic data, and other relevant variables. Additionally, generative Artificial Intelligence (AI) was employed to gain a deeper understanding of patient responses. The results indicate the extent and impact of pain in PD and provide valuable insights for more targeted and personalized management. This study lays the foundation for future research and the development of interventions aimed at improving the quality of life for individuals affected by this condition.
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Affiliation(s)
- Luana Conte
- Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics "E. De Giorgi" University of Salento, Lecce, Italy; Laboratory of Advanced Data Analysis for Medicine (ADAM) at the Laboratory of Interdisciplinary Research Applied to Medicine, University of Salento, Local Health Authority, Lecce, Italy.
| | - Roberto Lupo
- "San Giuseppe da Copertino" Hospital, Local Health Authority, Copertino, Lecce, Italy
| | - Pierluigi Lezzi
- "Veris Delli Ponti" Hospital, Local Health Authority, Scorrano, Lecce, Italy
| | - Alessio Pedone
- "Cardinal Giovanni Panico" Hospital, Tricase, Lecce, Italy
| | - Ivan Rubbi
- School of Nursing, University of Bologna, Faenza, Italy
| | - Alessia Lezzi
- ANT Italia ONLUS Foundation (National Cancer Association), Lecce, Italy
| | - Elsa Vitale
- Department of Mental Health, Local Health Authority, Bari, Italy
| | - Antonio Fasano
- "Vito Fazzi" Hospital, Local Health Authority, Lecce, Italy
| | - Giorgio De Nunzio
- Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics "E. De Giorgi" University of Salento, Lecce, Italy; Laboratory of Advanced Data Analysis for Medicine (ADAM) at the Laboratory of Interdisciplinary Research Applied to Medicine, University of Salento, Local Health Authority, Lecce, Italy.
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Kurihara K, Fujioka S, Mizutani Y, Watanabe H, Iwaoka K, Maeda T, Seki M, Tezuka T, Nakahara J, Konno T, Ishiguro T, Onodera O, Asano Y, Takahashi K, Rizos A, Chaudhuri KR, Tsuboi Y. Validation study of the Japanese version of the King's Parkinson's Disease Pain Scale and the King's Parkinson's Disease Pain Questionnaire. Parkinsonism Relat Disord 2024; 120:106012. [PMID: 38290410 DOI: 10.1016/j.parkreldis.2024.106012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The King's Parkinson's Disease Pain Scale (KPPS)/King's Parkinson's Disease Pain Questionnaire (KPPQ) was developed as a tool to quantitatively assess pain in patients with Parkinson's disease (PwPD). Here, we conducted a Japanese multicenter validation study to verify the reliability of KPPS/KPPQ in Japanese PwPD. METHODS PwPD, ≥20 years, with unexplained pain were included; those with a definitive primary cause of pain other than PD were excluded. A total of 151 patients who fulfilled the criteria were analyzed, and test-retest reliability was investigated in 25 individuals. RESULTS The 151 patients included 101 women (66.9 %); mean age 68.3 ± 9.9 years, mean disease duration 9.2 ± 5.2 years. The most frequent pain type in the KPPS classification was musculoskeletal pain (82.8 %). There was a positive correlation between KPPS total score and the Non-Motor Symptoms Scale (NMSS) total score, NMSS item 27, the Parkinson's disease sleep scale-version 2 (PDSS-2) total score, PDSS-2 item 10, the Parkinson's Disease Questionnaire-8 (PDQ-8) summary index and PDQ-8 item 7. Cronbach's alpha of KPPS was 0.626 (0.562-0.658) and the intraclass correlation coefficient of test-retest reliability was 0.740. Cronbach's alpha of KPPQ was 0.660 (0.617-0.705) and a test-retest reliability of kappa coefficient was 0.593 (0.0-1.0). CONCLUSIONS KPPS correlated well with other scales for assessing pain. KPPS correlated well with patients' quality of life, non-motor symptoms, and sleep disturbances. The reproducibility of KPPS/KPPQ makes it suitable for continuous evaluation of the same patient. On the other hand, the internal consistency of KPPS/KPPQ is rather low.
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Affiliation(s)
- Kanako Kurihara
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan
| | - Yasuaki Mizutani
- Department of Neurology, Fujita Health University School of Medicine, 1-98 Dengakugakugo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Hirohisa Watanabe
- Department of Neurology, Fujita Health University School of Medicine, 1-98 Dengakugakugo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Kazuhiro Iwaoka
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 2-1-1 Idai-dori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 2-1-1 Idai-dori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Toshiki Tezuka
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Takuya Konno
- Department of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8585, Japan
| | - Takanobu Ishiguro
- Department of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8585, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8585, Japan
| | - Yuri Asano
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashi dai Fuchu-City, Tokyo, 183-0042, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashi dai Fuchu-City, Tokyo, 183-0042, Japan
| | - Alexandra Rizos
- Parkinson's Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan.
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Liu M, Gu H, Hu J, Liu M, Luo Y, Yuan Y, Wu J, Zhou Y, Juan R, Cheng X, Zhuang S, Shen Y, Jin H, Chen J, Li K, Wang F, Liu C, Mao C. Higher cortical excitability to negative emotions involved in musculoskeletal pain in Parkinson's disease. Neurophysiol Clin 2024; 54:102936. [PMID: 38382137 DOI: 10.1016/j.neucli.2023.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE Changes in brain structure and neurotransmitter systems are involved in pain in Parkinson's disease (PD), and emotional factors are closely related to pain. Our study applied electroencephalography (EEG) to investigate the role of emotion in PD patients with chronic musculoskeletal pain. METHODS Forty-two PD patients with chronic musculoskeletal pain and 38 without were enrolled. EEG data were recorded under resting conditions, and while viewing pictures with neutral, positive, and negative content. We compared spectrum power, functional connectivity, and late positive potential (LPP), an event-related potential (ERP), between the groups. RESULTS PD patients with pain tended to have higher scores for the Hamilton Rating Scale for Depression (HRSD). In the resting EEG, mean β-band amplitude was significantly higher in patients with pain than in those without. Logistic regression analysis showed that higher HRSD scores and higher mean β-band amplitude were associated with pain. ERP analysis revealed that the amplitudes of LPP difference waves (the absolute difference between positive and negative condition LPP and neutral condition LPP) at the central-parietal region were significantly reduced in patients with pain (P = 0.029). Spearman correlation analysis showed that the amplitudes of late (700-1000 ms) negative versus neutral condition LPP difference waves were negatively correlated with pain intensity, assessed by visual analogue scale, (r = -0.393, P = 0.010) and HRSD scores (r = -0.366, P = 0.017). CONCLUSION Dopaminergic and non-dopaminergic systems may be involved in musculoskeletal pain in PD by increasing β-band activity and weakening the connection of the θ-band at the central-parietal region. PD patients with musculoskeletal pain have higher cortical excitability to negative emotions. The changes in pain-related EEG may be used as electrophysiological markers and therapeutic targets in PD patients with chronic pain.
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Affiliation(s)
- Ming Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; The First People's Hospital of Zhangjiagang City, Suzhou, China
| | - Hanying Gu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jingzhe Hu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Manhua Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yajun Luo
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuan Yuan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiayu Wu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Zhou
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ru Juan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyu Cheng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Sheng Zhuang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Jin
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fen Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Chunfeng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Chengjie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Zimmers S, Robieux L, Bungener C. Towards a better Comprehension and Management of Pain and Psychological Distress in Parkinson's: The Role of Catastrophizing. J Geriatr Psychiatry Neurol 2023; 36:351-365. [PMID: 36740398 DOI: 10.1177/08919887231154932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Pain is very prevalent in Parkinson's and challenging to manage. As many people with Parkinson's (PwP) with pain suffer from anxious and depressive symptoms, we examined the role of catastrophizing in mediating the relationship between pain and psychological distress for this population. METHODS 169 international PwP completed an online survey with socio-demographic and medical data. Participants completed psychometric tests to assess their pain (King's Parkinson's Disease Pain Questionnaire, McGill Pain Questionnaire and Brief Pain Inventory), psychological distress (Beck Depression Inventory and Parkinson Anxiety Scale), pain coping strategies (Coping Strategies Questionnaire) and pain catastrophizing (Pain Catastrophizing Scale). RESULTS Depending on the tool used, 82.8% to 95.2% of participants reported pain. 23.5 % and 67.5% of participants showed respectively significant levels of depressive and anxiety symptoms. Psychological distress was significantly correlated with the quality of pain (both sensory and affective dimensions). Statistical models highlighted the mediating role of catastrophizing in the relationship between psychological distress and pain in Parkinson's. CONCLUSION These findings offer new perspectives toward understanding the underlying mechanisms of pain in Parkinson's and for effective therapeutic intervention goals to facilitate adaptation to pain symptoms in Parkinson's.
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Affiliation(s)
- Sylvia Zimmers
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
| | - Léonore Robieux
- Laboratoire de Psychopathologie et Processus de Changement, Université Paris 8- IED, Saint-Denis, France
| | - Catherine Bungener
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
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Sartori AC, dos Santos FC, Lopes JDL, Santos VB, Okuno MFP. King's Parkinson's Disease Pain Questionnaire: reliability and convergent construct validity. Rev Bras Enferm 2023; 76:e20220379. [PMID: 37556691 PMCID: PMC10405386 DOI: 10.1590/0034-7167-2022-0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/17/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES to assess the evidence of reliability and convergent construct validity of the King's Parkinson's Disease Pain Questionnaire. METHODS psychometric study of 75 older adults with Parkinson's disease. The instrument was applied by two researchers separately and reapplied by one researcher 15 days later. In terms of reliability, internal consistency was assessed using the Cronbach's alpha test and stability using the intraclass correlation coefficient. Scores of the King's Parkinson's Disease Pain Questionnaire were compared to those of the Geriatric Pain Measure in the assessment of construct validity. RESULTS the mean Cronbach's alpha obtained between the three assessments was above 0.60, the intraclass correlation between the three assessments was above 0.90, and there was a weak but significant correlation between the two applied scales. CONCLUSIONS the instrument showed adequate evidence of convergent construct validity and reliability, and can be used in clinical practice.
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Seki M, Kurihara K, Konno T, Fujioka S, Tsuboi Y. [Characteristics and treatment of pain in Parkinson's disease]. Rinsho Shinkeigaku 2022; 62:763-772. [PMID: 36184418 DOI: 10.5692/clinicalneurol.cn-001733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Pain is a representative non-motor symptom in patients with Parkinson's disease (PD). Pain is one of the most common symptoms that plague patients with PD regardless of the stage of the disease, also it can exacerbate other symptoms, such as depression, anxiety or sleep disturbance, and lead to impaired quality of life. However, pain is often not adequately evaluated and treated. PD patients complain of a wide variety of pain, including both PD-related pain which caused by PD-specific symptoms, for example, rigidity, bradykinesia or motor fluctuation, and PD-unrelated pain, and it can be divided into central and peripheral depending on the site of the disorder. In the medical care of the pain, it is important to evaluate the type and severity of the pain using PD-specific assessment scales such as King's PD pain scale and to consider the evidence-based treatment methods according to the pathophysiology of the pain.
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Affiliation(s)
- Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Japan
| | - Kanako Kurihara
- Department of Neurology, Faculty of Medicine, Fukuoka University, Japan
| | - Takuya Konno
- Department of Neurology, Brain Research Institute, Niigata University, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Japan
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Rukavina K, Ocloo J, Krbot Skoric M, Sauerbier A, Thomas O, Staunton J, Awogbemila O, Trivedi D, Rizos A, Ray Chaudhuri K. Ethnic Disparities in Treatment of Chronic Pain in Individuals with Parkinson's Disease Living in the United Kingdom. Mov Disord Clin Pract 2022; 9:369-374. [PMID: 35392300 PMCID: PMC8974878 DOI: 10.1002/mdc3.13430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/30/2021] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Abstract
Background Over 80% people with Parkinson's disease (PD; PwP) live with chronic pain. Objective Whether ethnic disparities in receipt of appropriate analgesia exist among PwP with chronic pain living in the United Kingdom (UK). Methods A retrospective datamining of an existing King's PD Pain Questionnaire validation study dataset enrolling 300 PwP. Results 69 PwP: 23 Black (57% female), 23 Asian (57% female) and 23 White (65% female) had similar pain burden on the King's PD Pain Scale. Significantly more White PwP (83%) received pain relief compared to Black (48%) and Asian (43%) PwP (p = 0.016). The difference was most evident for opioid analgesics (White 43% vs. Black 4% vs. Asian 4%, p ≤ 0.001). Conclusions Ethnic disparities in the analgesic use among PwP with chronic pain living in the UK are evident in this retrospective analysis, prompting large‐scale studies and reinforcement of interventions to tackle the impact ethnicity might have on the successful analgesia.
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Affiliation(s)
- Katarina Rukavina
- Department of Basic and Clinical Neuroscience The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience at King's College London and King's College Hospital NHS Foundation Trust London UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
| | - Josephine Ocloo
- Centre for Implementation Science, Health Services, Population and Research Department Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London London UK
- National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) At King's College Hospital NHS Foundation Trust London UK
| | - Magdalena Krbot Skoric
- Laboratory for Cognitive and Experimental Neurophysiology, Department of Neurology University Hospital Centre Zagreb Zagreb Croatia
| | - Anna Sauerbier
- Department of Basic and Clinical Neuroscience The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience at King's College London and King's College Hospital NHS Foundation Trust London UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
- Department of Neurology University Hospital Cologne Cologne Germany
| | | | - Juliet Staunton
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
| | - Olabisi Awogbemila
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
| | - Dhaval Trivedi
- Department of Basic and Clinical Neuroscience The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience at King's College London and King's College Hospital NHS Foundation Trust London UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
| | - Alexandra Rizos
- Department of Basic and Clinical Neuroscience The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience at King's College London and King's College Hospital NHS Foundation Trust London UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
| | - K. Ray Chaudhuri
- Department of Basic and Clinical Neuroscience The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience at King's College London and King's College Hospital NHS Foundation Trust London UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital London UK
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Kurihara K, Fujioka S, Mishima T, Konno T, Seki M, Tsuboi Y. [Japanese translation and linguistic validation of King's Parkinson's Disease Pain Scale (KPPS) and King's Parkinson's Disease Pain Questionnaire (KPPQ)]. Rinsho Shinkeigaku 2021; 62:15-21. [PMID: 34924474 DOI: 10.5692/clinicalneurol.cn-001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain is one of the most frequent non-motor symptoms associated with Parkinson's disease (PD) and it has a great impact on patient's quality of life. Thus, its quantitative evaluation is critical in establishing therapeutic evidence. The King's Parkinson's Disease Pain Scale (KPPS) was introduced as a scale of pain specific to PD in 2015. As a follow-up to the evaluator-based KPPS, the patient-based questionnaire, the King's Parkinson's Disease Pain Questionnaire (KPPQ), was introduced in 2018. We developed a linguistically validated Japanese version of the KPPS and KPPQ, and the process of its construction is reported in this study.
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Affiliation(s)
- Kanako Kurihara
- Department of Neurology, Fukuoka University School of Medicine
| | | | | | - Takuya Konno
- Department of Neurology, Brain Research Institute, Niigata University
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University School of Medicine
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11
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Stoyanova-Piroth G, Milanov I, Stambolieva K. Translation, adaptation and validation of the Bulgarian version of the King's Parkinson's Disease Pain Scale. BMC Neurol 2021; 21:357. [PMID: 34525961 PMCID: PMC8442462 DOI: 10.1186/s12883-021-02392-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of the present study was to translate and cross-culturally adapt the King’s Parkinson’s Disease Pain Scale (KPPS) into Bulgarian and to investigate its psychometric properties in order to provide a validated Parkinson’s disease-specific pain instrument in Bulgarian language (KPPS-BG). Methods Translation into Bulgarian and a cultural adaptation were performed to obtain KPPS-BG. A total of 162 patients with idiopathic Parkinson’s disease were screened for pain using the complementary to the KPPS questionnaire – King’s Parkinson’s Disease Pain Questionnaire (KPPQ). KPPS-BG domain and total scores were calculated and internal consistency, construct validity and test-retest reliability were examined for 129 patients having one or more positive items in the KPPQ-BG. Results 79.6 % of the patients reported one or more types of pain. The most common type was musculoskeletal pain (83.7 %), followed by nocturnal pain (55.0 %), fluctuation-related pain (50.1 %), radicular pain (43.4 %), chronic pain (31.0 %), discoloration, edema/swelling (27.1 %) and, oro-facial pain (14.3 %). Mean KPPS-BG total score was 21.1 ± 17.3 SD. KPPS-BG showed a good reliability (Cronbach’s alpha 0.75). The test-retest reliability of the KPPS-BG was high and the intraclass correlation coefficient was 0.92, demonstrating а good repeatability. KPPS-BG total score was higher in patients with postural instability gait difficulty motor subtype, compared to tremor-dominant or indeterminate subtype. Significant positive correlations were found between KPPS-BG total score and modified H&Y, Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III. Conclusions The KPPS-BG constitutes a reliable, comprehensive and useful tool for pain assessment in native Bulgarian patients with Parkinson’s disease.
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Affiliation(s)
- Galina Stoyanova-Piroth
- St. Naum Hospital of Neurology and Psychiatry, Medical University, 1, Louben Roussev str., 1113, Sofia, Bulgaria.
| | - Ivan Milanov
- St. Naum Hospital of Neurology and Psychiatry, Medical University, 1, Louben Roussev str., 1113, Sofia, Bulgaria
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12
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Mylius V, Möller JC, Bohlhalter S, Ciampi de Andrade D, Perez Lloret S. Diagnosis and Management of Pain in Parkinson's Disease: A New Approach. Drugs Aging 2021; 38:559-577. [PMID: 34224103 DOI: 10.1007/s40266-021-00867-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 12/27/2022]
Abstract
Pain is a frequent and disabling non-motor feature of Parkinson's disease (PD). The recently proposed PD Pain Classification System (PD-PCS) allows for an association of pain with PD to be determined before being allocated to the main pain mechanism (i.e. nociceptive, neuropathic, and nociplastic). In this article, previous studies on treatments for pain in PD are summarized according to the pain mechanisms. A mechanistic approach to treatment is discussed. We suggest that the first step should be optimizing dopaminergic therapy before other therapy is started. When these treatments remain unsuccessful, further causes of pain must be considered. The role of drugs, invasive treatments, and physiotherapeutic interventions are discussed with a focus on older PD patients and considering polypharmacy, altered pharmacokinetics, and comorbidities.
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Affiliation(s)
- Veit Mylius
- Department of Neurology, Center for Neurorehabilitation, 7317, Valens, Switzerland. .,Department of Neurology, Philipps University, Marburg, Germany. .,Department of Neurology, Kantonsspital, St. Gallen, Switzerland.
| | - Jens Carsten Möller
- Department of Neurology, Philipps University, Marburg, Germany.,Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Stephan Bohlhalter
- Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.,Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Daniel Ciampi de Andrade
- Centro de Dor, Departamento de Neurologia da Faculdade de Medicina da, Universidade de Sao Paulo, Sao Paulo, Brazil.,Instituto do Cancer de Sao Paulo, Octavio Frias de Oliveira, Sao Paulo, Brazil.,Hospital das Clinicas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Santiago Perez Lloret
- LIM 62, Biomedical Research Center (CAECIHS-UAI), National Research Council (CONICET), Buenos Aires, Argentina.,Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina.,Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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Abstract
Parkinson's disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review summarizes the epidemiological and clinical data, research on the diagnostic approaches and the interventions available in the Eastern European country of Romania. This scoping review follows the recommendations on the scoping review methodology by Joanna Briggs Institute. We searched four databases (up to 27 January 2021). The data of eligible studies were extracted in standardized forms. We identified 149 unique studies from 1133 records, with 11 epidemiological studies, 52 studies investigating clinical aspects of PD, 35 studies on diagnostic tools, and 51 intervention studies. A narrative synthesis is provided and placed in a historical context. Our review revealed a considerable increase in the Romanian research on PD in the latest 15 years, which largely follows international trends. However, we also identified several research gaps that provide useful information for policymakers, public health specialists, and clinicians.
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Affiliation(s)
- Elena Cecilia Rosca
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Raluca Tudor
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Amalia Cornea
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Mihaela Simu
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
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Taghizadeh G, Joghataei MT, Goudarzi S, Bakhsheshi M, Habibi SAH, Mehdizadeh M. King's Parkinson's disease pain scale cut-off points for detection of pain severity levels: A reliability and validity study. Neurosci Lett 2021; 745:135620. [PMID: 33429001 DOI: 10.1016/j.neulet.2020.135620] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/26/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pain is one of the most common non-motor symptoms in Parkinson's disease (PD). Using an appropriate and specific measuring tool would be helpful in managing the pain. King's Parkinson's disease Pain Scale (KPPS) is an instrument designed to specifically measure pain in people with PD. PURPOSE This study aimed to examine the psychometric properties of the Persian version of KPPS (KPPS-P) and its cut-off points for pain severity levels. METHODS A total of 480 people with PD (with a mean (SD) age of 60.89 (10.98)) were recruited. The acceptability of KPPS-P was calculated. The structural validity and discriminant validity for different levels of pain was explored via the factor analysis, and Receiver Operating Characteristics (ROC) curves, respectively. Internal consistency, test-retest, and inter-rater reliability were estimated by Cronbach's alpha and Interclass Correlation coefficient (ICC). Convergent validity was established between KPPS-P and other scales including Visual Analog Scale-Pain, Douleur Neuropathic 4, Brief Pain Inventory, Short-form McGill Pain Questionnaire-2, and Parkinson's Disease-8. RESULTS A significant floor effect was observed. The exploratory factor analysis revealed 4 factors. Cronbach's alpha and ICC values were higher than 0.80. The correlation range between KPPS-P and other scales was 0.35-0.76. Cut-off points of 0, 17, and 68 were obtained to discriminate pain severity levels between no pain, mild, moderate, and severe pain, respectively, with sensitivity and specificity above 0.80. CONCLUSION Our results indicate that the Persian version of KPPS not only has acceptable psychometric properties to assess pain in PD but also has the ability to distinguish between different levels of pain severity.
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Affiliation(s)
- Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran.
| | - Mohammad Taghi Joghataei
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Sepideh Goudarzi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tehran University of Medical Science, Tehran, Iran.
| | - Merat Bakhsheshi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Semnan University of Medical Science, Semnan, Iran.
| | - Sayed Amir Hasan Habibi
- Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran.
| | - Maryam Mehdizadeh
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Abstract
This article reviews scales that have been developed for, validated in, and/or frequently used across multiple movement disorders with a focus on assessment of motor and nonmotor symptoms of Parkinson disease. Rating scales used in other disease states include those for essential tremor, dystonia (generalized dystonia, cervical dystonia, and blepharospasm), Tourette syndrome, Huntington disease, tardive dyskinesia, Wilson disease, ataxia, and functional movement disorders. Key features of each scale as well as cited criticisms and limitations of each scale are also discussed. Lastly, the article briefly discusses the emerging role of digital assessment tools (both wearable devices and digital interface applications).
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Affiliation(s)
- Arjun Tarakad
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 7200 Cambridge Street Suite 9A, Houston, TX 77030, USA.
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16
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Buhidma Y, Rukavina K, Chaudhuri KR, Duty S. Potential of animal models for advancing the understanding and treatment of pain in Parkinson's disease. NPJ Parkinsons Dis 2020; 6:1. [PMID: 31934609 DOI: 10.1038/s41531-019-0104-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/02/2019] [Indexed: 12/21/2022]
Abstract
Pain is a commonly occurring non-motor symptom of Parkinson’s disease (PD). Treatment of pain in PD remains less than optimal and a better understanding of the underlying mechanisms would facilitate discovery of improved analgesics. Animal models of PD have already proven helpful for furthering the understanding and treatment of motor symptoms of PD, but could these models offer insight into pain in PD? This review addresses the current position regarding pain in preclinical models of PD, covering the face and predictive validity of existing models and their use so far in advancing understanding of the mechanisms contributing to pain in PD. While pain itself is not usually measured in animals, nociception in the form of thermal, mechanical or chemical nociceptive thresholds offers a useful readout, given reduced nociceptive thresholds are commonly seen in PD patients. Animal models of PD including the reserpine-treated rat and neurodegenerative models such as the MPTP-treated mouse and 6-hydroxydopamine (6-OHDA)-treated rat each exhibit reduced nociceptive thresholds, supporting face validity of these models. Furthermore, some interventions known clinically to relieve pain in PD, such as dopaminergic therapies and deep brain stimulation of the subthalamic nucleus, restore nociceptive thresholds in one or more models, supporting their predictive validity. Mechanistic insight gained already includes involvement of central and spinal dopamine and opioid systems. Moving forward, these preclinical models should advance understanding of the cellular and molecular mechanisms underlying pain in PD and provide test beds for examining the efficacy of novel analgesics to better treat this debilitating non-motor symptom.
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Soyuer F, Gültekin M, Cankurtaran F, Elmalı F. Reliability and validity of the Turkish version of king's Parkinson's disease pain scale. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_34_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rukavina K, Leta V, Sportelli C, Buhidma Y, Duty S, Malcangio M, Ray Chaudhuri K. Pain in Parkinson's disease: new concepts in pathogenesis and treatment. Curr Opin Neurol 2019; 32:579-88. [DOI: 10.1097/wco.0000000000000711] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Cuomo A, Crispo A, Truini A, Natoli S, Zanetti O, Barone P, Cascella M. Toward more focused multimodal and multidisciplinary approaches for pain management in Parkinson's disease. J Pain Res 2019; 12:2201-2209. [PMID: 31413618 PMCID: PMC6660097 DOI: 10.2147/jpr.s209616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/02/2019] [Indexed: 12/18/2022] Open
Abstract
In Parkinson’s disease (PD), pain represents a significant issue in terms of prevalence, clinical features, and treatment. Painful manifestations not strictly related to the disease are often amplified by the motor dysfunction. On the other hand, typical pain problems may specifically concern this vulnerable population. In turn, pain may have a deep impact on patients’ health-related quality of life. However, pain treatment in PD remains an unmet need as only about half of patients with pain use analgesics and pain is often managed by simply increasing doses of PD medications. In this complex scenario, pain treatments should follow multimodal approaches through a careful combination of pharmacological agents with non-pharmacological strategies, depending on the type of pain and the clinical context. A multidisciplinary approach involving medical specialists from different disciplines could be a winning strategy to address the issue. This work is aimed to provide practical suggestions useful for different types of clinicians and care professionals for pain management in this vulnerable population.
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Affiliation(s)
- Arturo Cuomo
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Anna Crispo
- S.C. Epidemiologia e Biostatistica, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Andrea Truini
- Department of Human Neuroscience, University Sapienza, Rome, Italy
| | - Silvia Natoli
- Department of Clinical Science and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Orazio Zanetti
- U.O. Alzheimer, IRCCS Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Paolo Barone
- Center for Neurodegenerative Disease-CEMAND, University of Salerno, Fisciano, Italy
| | - Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
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Filippi M, Sarasso E, Agosta F. Resting-state Functional MRI in Parkinsonian Syndromes. Mov Disord Clin Pract 2019; 6:104-117. [PMID: 30838308 DOI: 10.1002/mdc3.12730] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/28/2018] [Accepted: 01/16/2019] [Indexed: 01/18/2023] Open
Abstract
Background Functional MRI (fMRI) has been widely used to study abnormal patterns of functional connectivity at rest in patients with movement disorders such as idiopathic Parkinson's disease (PD) and atypical parkinsonisms. Methods This manuscript provides an educational review of the current use of resting-state fMRI in the field of parkinsonian syndromes. Results Resting-state fMRI studies have improved the current knowledge about the mechanisms underlying motor and non-motor symptom development and progression in movement disorders. Even if its inclusion in clinical practice is still far away, resting-state fMRI has the potential to be a promising biomarker for early disease detection and prediction. It may also aid in differential diagnosis and monitoring brain responses to therapeutic agents and neurorehabilitation strategies in different movement disorders. Conclusions There is urgent need to identify and validate prodromal biomarkers in PD patients, to perform further studies assessing both overlapping and disease-specific fMRI abnormalities among parkinsonian syndromes, and to continue technical advances to fully realize the potential of fMRI as a tool to monitor the efficacy of chronic therapies.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute Vita-Salute San Raffaele University Milan Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute Vita-Salute San Raffaele University Milan Italy
| | - Elisabetta Sarasso
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute Vita-Salute San Raffaele University Milan Italy.,Laboratory of Movement Analysis San Raffaele Scientific Institute Milan Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute Vita-Salute San Raffaele University Milan Italy
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Martinez-Martin P, Rizos AM, Wetmore JB, Antonini A, Odin P, Pal S, Sophia R, Carroll C, Martino D, Falup-Pecurariu C, Kessel B, Andrews T, Paviour D, Trenkwalder C, Chaudhuri KR. Relationship of Nocturnal Sleep Dysfunction and Pain Subtypes in Parkinson's Disease. Mov Disord Clin Pract 2018; 6:57-64. [PMID: 30746417 DOI: 10.1002/mdc3.12694] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/31/2018] [Accepted: 09/26/2018] [Indexed: 01/04/2023] Open
Abstract
Background Little research has been conducted regarding the relationship between sleep disorders and different pain types in Parkinson's disease (PD). Objective To explore the influence of the various pain subtypes experienced by PD patients on sleep. Methods Three hundred consecutive PD patients were assessed with the PD Sleep Scale-Version 2 (PDSS-2), King's PD Pain Scale (KPPS), King's PD Pain Questionnaire (KPPQ), Visual Analog Scales for Pain (VAS-Pain), and Hospital Anxiety and Depression Scale. Results According to the PDSS-2, 99.3% of our sample suffered from at least one sleep issue. Those who reported experiencing any modality of pain suffered significantly more from sleep disorders than those who did not (all, P < 0.003). The PDSS-2 showed moderate-to-high correlations with the KPPS (rS = 0.57), KPPQ (0.57), and VAS-Pain (0.35). When PDSS-2 items 10 to 12 (pain-related) were excluded, the correlation values decreased to 0.50, 0.51, and 0.28, respectively, while these items showed moderate-to-high correlations with KPPS (0.56), KPPQ (0.54), and VAS-Pain (0.42). Among the variables analyzed, multiple linear regression models suggested that KPPS and KPPQ were the most relevant predictors of sleep disorders (as per the PDSS-2), although following exclusion of PDSS-2 pain items, depression was the relevant predictor. Depression and anxiety were the most relevant predictors in the analysis involving the VAS-Pain. Regression analysis, considering only the KPPS domains, showed that nocturnal and musculoskeletal pains were the best predictors of overall nocturnal sleep disorder. Conclusions Pain showed a moderate association with nocturnal sleep dysfunction in PD. Some pain subtypes had a greater effect on sleep than others.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology, Carlos III Institute of Health Madrid Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health Madrid Spain
| | - Alexandra M Rizos
- Institute of Psychiatry, Psychology, & Neuroscience at King's College and King's College Hospital NHS Foundation Trust London United Kingdom
| | - John B Wetmore
- National Center of Epidemiology, Carlos III Institute of Health Madrid Spain
| | | | - Per Odin
- Department of Neurology University of Lund Lund Sweden
| | - Suvankar Pal
- Department of Neurology Forth Valley Royal Hospital Larbert Scotland United Kingdom
| | - Rani Sophia
- Department of Geriatric Medicine Yeovil Hospital Somerset United Kingdom
| | | | - Davide Martino
- Department of Clinical Neurosciences University of Calgary Calgary Canada
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Emergency Clinic Hospital, Faculty of Medicine Transilvania University Brasov Romania
| | - Belinda Kessel
- Medicine for the Elderly Princess Royal University Hospital, King's College Hospital Kent United Kingdom
| | | | | | - Claudia Trenkwalder
- Department of Neurosurgery University Medical Center, Goettingen, Paracelsus-Elena Hospital Kassel Germany
| | - Kallol Ray Chaudhuri
- Institute of Psychiatry, Psychology, & Neuroscience at King's College and King's College Hospital NHS Foundation Trust London United Kingdom
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