Clinical Characteristics Of Patients With Pain In Parkinson’s Disease And Preliminary Exploration Of Pain Classification Of Parkinson’s Disease Based On KPPS

[Objective]The incidence of pain in patients with Parkinson’s disease(PD)was analyzed.To explore the influencing factors of pain in PD patients and the related factors affecting the severity of pain in PD patients;The King’s Parkinson’s Disease Pain Scale(KPPS)was compared with the Visual Analogue Scale(VAS)of the Brief Pain Inventory(BPI).KPPS scores were used to classify pain in PD,and compared with Ford classification,so as to explore a more meaningful pain in PD classification method for clinical research.[Methods]In February 2019 to February 2021 in the First Affiliated Hospital of Kunming Medical University neurology clinic of 88 patients with PD basic information collection and relevant assessment scale respectively,at the same time,record the patient’s body mass index(BMI),age and gender culture degree and other basic situation,and according to the MDS-part UPDRS motor score of each subgroup average ratio PD patients divided into tremor type(tremor dominate.TD)Postural Instability/Gait Disorder(PIGD)and Indeterminate(IT)were divided into three clinical subtypes using SPSS 25.0 of the indicators of the presence of pain patients with PD were tested for significant differences of project,significant differences to the index correlation analysis with whether comorbid pain,and to collect all items with stepwise regression analysis,whether pain symptoms for PD independent risk factors of patients with pain,Correlation analysis was made between KPPS scale score and BPI scale score VAS scale score.KPPS pain scale score of pain patients with other scale scores,correlation analysis to find the factors affecting the severity of pain using KPPS pain score each and construct a distinction between PD hybrid and feasible new model,the classification results compare to Ford,taxonomy,classification of PD pain more clinical significance are discussed P<0.05 indicates statistical significance,and the results are displayed in a list or graph.[Results]1.Among the 88 PD patients,35 patients(39.8%)had pain,among which the most common pain site was lower limbs(85.7%),the most common pain type was musculoskeletal pain(68.6%),and 12 patients(34.3%)had more than one type of pain;2.PD patients with pain were older than PD patients without pain(68.09±5.22 vs.62.87±11.47,P=0.040),longer course of disease[5(1,10)vs.2(1,10),P=0.004],higher education level(P=0.027),higher PDSS-2 score(18.74±10.40 vs.14.06±8.80,P=0.025);3.The duration of disease(rs=0.220,P=0.040)was significantly positively correlated with the occurrence of pain in PD patients.Age(rs=0.305,P=0.004),education level(rs=0.238,P=0.026),PDSS2 score(rs=0.247,P=0.021)was signifi cantly positively correlated with the occurrence of pain in PD patients.4.Multivariate logistic regression analysis showed that PD patients with pain and long course of disease(OR=1.307,95%CI:1.065-1.606,P=0.011),high PDSS-2 score(OR=1.206,95%CI:1.086-1.340,P<<0.05)was associated with higher HAMD score(OR=1.179,95%CI:1.036-1.341,P=0.013).5.The scores of KPPS scale were significantly positively correlated with those of VAS scale and BPI scale;KPPS scale score was negatively correlated with Schwab&England activity scale score(rs=-0.375,P=0.027),and positively correlated with PDQ39 scale score(rs=0.494,P=0.003),HAMD scale score(rs=0.485,P=0.003)and HAMA scale score(rs=0.357,P=0.035).6.There were significant differences in the duration of disease(P=0.013),VAS score(P=0.016),BPI score(P=0.001),the movement part score of MDS-UPDRS(P=0.009),H-Y score(P=0.006),PDQ39 score(P=0.000),PDSS-2 score(P=0.029),ESS score(P=0.044),HAMD score(P=0.006),HAMA score(P=0.018)between the new model constructed by KPPS and the single group.There were differences in the VAS score(P=0.045)BPI score(P=0.010)PDQ39 score(P=0.021)and RBDSQ score(P=0.016)between the mixed PD pain group and the single PD pain group defined by Ford classification.[Conclusions]1.The incidence of pain in PD patients was high and lower limb pain was the most common.According to Ford classification he most common type of pain was musculoskeletal pain.2.Pain in PD patients may be related to longer course of disease,but not significantly related to H-Y staging,severity of motor symptoms and clinical subtypes.3.Longer disease duration,higher PDSS-2 score and higher HAMD score may be independent risk factors of PD patients with pain.4.For PD patients with pain,there is a significant positive correlation between the KPPS scale and the widely used pain scale BPI and VAS,which can better reflect the severity of pain.5.PD patients with more severe chronic pain may be associated with more severe depression and anxiety,as well as lower daily activity and poorer quality of life.6.Compared with mixed pain and single pain defined by Ford classification,the difference between the mixed group and single pain defined by KPPS construction model is greater,and the pain model constructed by KPPS subitem score may have more clinical significance.