Research On Clinical Characteristics And Cognitive Function Of Parkinson’s Disease Patients With Pain

Objective:1. To assess the clinical features of chronic pain in Parkinson’s disease patients;2. To observe the relationship between pain and cognitive function in PD patients.Methods:From January2009to July2013,343PD patients in Department of Neurology, the Second Affiliated Hospital of Soochow University were enrolled to this study and150age, gender and education matched healthy controls were assessed. The chronic pain of two groups was assessed with visual analogue scale (VAS) and Brief pain inventory (BPI). We analyzed the localization, therapy, quality of life on90PD patients and50controls with chronic pain.180PD patients were evaluated by Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale (H-Y), Hamilton Rating Scale for Depression (HRSD), Mini-Mental State Examination (MMSE), PD Quality of Life Questionnaire (PDQL) and non-motor Symptom Quest(NMSQ). Logistic regression analysis was used to assess the possible predictors for PD patients with pain.56PD patients with pain from June2012to December2012were assessed by the types of pain and Montreal Cognitive Assessment (MoCA).Results:1. The incidence of pain in PD patients was higher than that in healthy controls (47.8%vs33.3%P=0.003); The pain in PD patients usually focused on the extremities, while pain in controls was often located on necks and waists. BPI was different between PD groups and controls in general activity, mood, normal work, walking ability, sleep and enjoyment of life (P=0.001,0.001,0.004,0.01,0.003,0.00).2. PD patients with pain had higher UPDRS, H-Y stage, HRSD, PDQL and LED scores than those without pain. Logistic regression model showed that HRSD scores had a significant independent predictive value with pain (OR=1.16P=0.000).3. PD patients with pain had lower scores of delayed recall than patients without pain (1.9±1.3vs2.5±1.3P=0.02). Patients whose pain symptoms occurred before movement symptoms had a lower score of delayed recall (1.2±1.2vs2.2±1.3P=0.015). Conclusions:1. Pain occurred more in PD patients than those of control group. There was no effective treatment on the pain in PD patients, and PD patients with pain have poorer quality of life.2. The mechanism of pain may be different in PD patients and normal controls. However, the pain and motor symptoms may share similar mechanisms.3. Depression was probably a key predictor of pain in PD.4. In PD patients with pain, musculoskeletal pain was the most common pain, and the delayed recall was the main impaired cognition.