Study On The Characteristics And Correlation Of Pain In Parkinson''s Disease

Objective Pain is one of the most common Non-Motor Symptoms(NMS)of Parkinson's disease(PD),which seriously affects the daily life and work of PD patients and significantly reduces their quality of life.Through the investigation of PD patients,this study attempts to find out the pain characteristics,incidence rate and related influencing factors of PD patients,so as to alleviate or treat pain through appropriate intervention of related factors.Methods PD patients admitted to the First affiliated Hospital of Dalian Medical University from September 2017 to November 2018 were selected.All PD patients met the diagnostic criteria for PD set by the United Kingdom(UK)Brain Bank.At the same time,control subjects with pain at a certain part of the body matching age and gender with the case group were randomly selected as the non-PDpatients with pain,and healthy control subjects with age and gender matching with the case group were randomly selected as the normal control group.Relevant clinical data required by each group of patients were collected.(1)Classification and evaluation of pain:The Brief Pain Inventory(BPI)and Visual Analogue scale(VAS)were used to classify and evaluate the pain degree of the enrolled patients,and the types of PD pain were distinguished according to the description of PD patients.(2)Evaluation of motor symptoms in PD patients: The Unified Parkinson's Disease Rating Scale III(UPDRSIII)was used to evaluate the motor symptoms of PD patients.H-Ystages are used to assess the severity of PD.(3)Evaluation of NMSin PD patients:Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the NMS of PD patients.In addition,the above scale was used to evaluate other enrolled patients.(4)Levodopa Equivalent Daily Dose(LEDD)was calculated for PD patients.Results A total of 111 PD patients were included in this study,including 58 patients(52.25%)with pain,and 48 patients(82.76%)with moderate or above pain.VAS score was 5.45±1.72.Twelve of the patients reported pain that occurred during withdrawal,while the rest reported pain that was independent of withdrawal.Among PD patients with pain,36(62.07%)patients had musculoskeletal pain,28(48.28%)patients had dystonic pain,20(34.48%)patients had radicular-peripherical neuropathic pain,and 5(8.62%)patients had neuropathic pain.30 PD patients had lower limb pain,15 PD patients had upper limb pain,26 PD patients had back or lower back pain,15 PD patients had neck pain,12 PD patients had shoulder pain,6 PD patients had foot pain,and 2 PD patients had headache.The age difference between PD patients with pain and PD patients without pain was statistically significant(years of age,65.29±9.38vs70.83±7.59)(P<0.05),and the age of PD patients with pain was relatively small.There was no statistically significant difference between the two groups.There was a statistically significant difference in age between the PD patients with pain and the non-PD patients with pain group(years of age,65.29±9.38 vs 69.24±9.33)(P<0.05),while there was no statistically significant difference in gender between the two groups.There was no statistically significant difference in age between the PD patients with pain and the normal control group,and there was no statistically significant difference in gender between the two groups.There was a statistically significant difference in age between the PD patients without pain and the normal control group(years of age,70.83±7.59 vs 66.36±9.83)(P<0.05),while there was no statistically significant difference in gender between the two groups.The difference of UPDRSIIIscore between PD patients with pain group and PD patients without pain group was statistically significant(scores,38.60±11.69 vs 22.32±9.10)(P<0.05),and the score was higher in PD patients with pain group.There was no significant difference in H-Ystages between PD patients with pain group and PD patients without pain.There was no significant difference in H-Ystages,MMSE score,Mo CA score,HAMA score,HAMD score and PSQI score between PD patients with pain group and PD patients without pain group.LEDD difference between PD patients with pain group and PD patients without pain group was statistically significant(P<0.05).In addition,LEDD was less in PD patients withpain group.The differences of Mo CA score,MMSE score,HAMA score,HAMD score and PSQI score between PD patients with pain group and non-PD patients with pain group were statistically significant.The differences of Mo CA score,MMSE score,HAMA score,HAMD score and PSQI score between PD patients with pain group and normal control group were statistically significant.There were statistically significant differences in Mo CA score,MMSE score,HAMA score,HAMD score and PSQI score between the PD patients without pain group and the normal control group.In the analysis of the clinical correlation factors of PD pain,UPDRSIII(r=0.283,p=0.031)was found to be the significant influencing factors for PD-related pain,and there was a positive correlation between them.Other factors were not significantly correlated.Conclusions(1)In PD,the incidence of PD patients with pain was 52.25%.Musculoskeletal pain is the most common type of PD-related pain.(2)PD patients with pain may be generally younger in age.(3)PD-relatedpain may be significantly correlated with the UPDRSIII score,and the higher the UPDRSIII score of PD patients withpain,the more obvious the pain degree of patients may be.(4)Anxiety,depression,cognitive dysfunction and sleep disorder may be common in PD patients.(5)LEDD dosage in PD patients with pain is less than that in PD patients without pain.