Risk Factors For Cognitive Function Of Parkinson's Disease Patients With Pain

Objective:The aim of this study is to investigate the clinical characteristics of PD patients with pain and study related risk factors in the cognitive function of PD patients with pain.Methods:Between November 2017 to December 2019,we enrolled 150 cases of patients who diagnosed with primary PD in the Second Affiliated Hospital of Soochou University Hospital.We used third part the Unified Parkinson's Disease Rating Scale(UPDRS ?),the Hoehn-Yahr stage(H-Y),Montreal Cognitive Assessment(MoCA),Hamilton Rating Scale for Anxiety(HAMA),Hamilton Depression Rating Scale(HAMD-17),Pittsburgh Sleep Quality Index(PSQI)to evaluated the Motor and non-motor symptoms;we investigated whether they were suffering from pain and recorded the location of pain and used the method of visual analog pain score(Visual Analogue Scale,VAS)to assess the degree of pain,and serum levels of uric acid,vitamin D,homocysteine,folic acid,and vitamin B12 were measured.We compared the clinical characteristics and cognitive functions in PD patients with and without pain,and analyzed the risk factors affecting cognitive impairment in PD patients with pain by multivariate Logistic regression.ResultsIn this study,70 PD patients had pain(46.67%),and the most commonly involved location of pain were the extremities(65.71%).The most common type of pain was skeletal muscle pain(48.57%).The course of disease,Levodopa equivalent daily dose(LED),UPDRS-?,H-Y,HAMD,HAMA,MOCA,PSQI were higher in the group of PD patients with pain than those without pain(P<0.05).Logistic regression analysis showed that only the course of disease was significant predictive value in PD patients with pain(P<0.05).In PD patients with pain,the incidence rate of patients with cognitive function was 70%.Multivariate Logistic regression analysis showed that serum uric acid level(OR=0.98,P=0.035),and vitamin D level(OR=0.85,P=0.014)were correlated with cognitive function of PD patients with pain.ConclusionsPD patients with pain have a longer course of disease,a higher dose of LED,a more severe of cognitive function,and have worse mental disorders and sleep disorders.The course of the disease is a risk factor in PD patients with pain.In addition,the incidence of cognitive impairment was higher in PD patients with pain then PD patients without pain.Lower Serum uric acid level and vitamin D level were risk factors for cognitive impairment in PD patients with pain.