PAPER

Pain and motor complications in Parkinson’s disease

M Tinazzi¹, C Del Vesco¹, E Fincati³, S Ottaviani², N Smania¹, G Moretto², A Fiaschi¹, D Martino⁴ and G Defazio⁴

¹ Dipartimento di Scienze Neurologiche e della Visione, Sezione di Neurologia Riabilitativa, Università di Verona, Verona, Italy
² Unita Operativa Neurologia Ospedale Civile Borgo Trento, Verona
³ Clinica Neurologica Policlinico GB Rossi, Verona
⁴ Dipartimento di Scienze Neurologiche e Psichiatriche, Università di Bari, Bari, Italy

Correspondence to:
Correspondence to:
Dr M Tinazzi
Unità Operativa di Neurologia, OC Borgo Trento, Piazzale Stefani 1, 37100 Verona, Italy; michele.tinazzi{at}mail.azosp.vr.it

Aims: To study the association of pain with motor complications in 117 patients with Parkinson’s disease.

Methods: Patients were asked to refer any pain they experienced at the time of study and lasting since at least 2 months. Basic parkinsonian signs and motor complications (including motor fluctuations and dyskinesia) were assessed and Unified Parkinson’s Disease Rating Scale (UPDRS) motor score part III (during on) and part IV were calculated. Information on age, sex, duration of disease, use of dopamine agonists and levodopa, years of levodopa treatment and current levodopa dosage, medical conditions possibly associated with pain, and depression were collected. Single and multiple explanatory variable logistic regression models were used to check the association of pain with the investigated variables.

Results: Pain was described by 47 patients (40%) and could be classified into dystonic (n.19) and non dystonic pain (n.16); in 12 patients both types coexisted. Multiple explanatory variable logistic regression models indicated a significant association of pain with motor complications (adjusted OR, 5.7; 95% CI, 2 to 16.5; p = 0.001). No association was found between pain, dystonic or non dystonic, and the other investigated variables including medical conditions known to be associated to pain in the general population. There was a significant correlation (r = 0.31, p<0.05) between severity of pain (measured on a Visual Analogue Scale) and severity of motor complications (UPDRS part IV).

Conclusions: Pain may be a representative feature of Parkinson’s disease frequently associated with motor complications. The association is independent of a number of potentially relevant demographic and clinical variables.

Abbreviations: UPDRS, Unified Parkinson’s Disease Rating Scale; VAS, Visual Analogue Scale

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Canavero, S. (2009). Central Pain and Parkinson Disease. Arch Neurol 66: 282-283 [Full Text]  
• Mylius, V, Engau, I, Teepker, M, Stiasny-Kolster, K, Schepelmann, K, Oertel, W H, Lautenbacher, S, Moller, J C (2009). Pain sensitivity and descending inhibition of pain in Parkinson's disease. J. Neurol. Neurosurg. Psychiatry 80: 24-28 [Abstract] [Full Text]  
• Samura, K, Miyagi, Y, Morioka, T, Murakami, N, Yoshida, F, Hashiguchi, K, Sakae, N, Yamasaki, R, Kawaguchi, M, Nagata, S, Sasaki, T (2008). Intractable facial pain in advanced Parkinson's disease alleviated by subthalamic nucleus stimulation. J. Neurol. Neurosurg. Psychiatry 79: 1410-1411 [Full Text]  
• Defazio, G., Berardelli, A., Fabbrini, G., Martino, D., Fincati, E., Fiaschi, A., Moretto, G., Abbruzzese, G., Marchese, R., Bonuccelli, U., Del Dotto, P., Barone, P., De Vivo, E., Albanese, A., Antonini, A., Canesi, M., Lopiano, L., Zibetti, M., Nappi, G., Martignoni, E., Lamberti, P., Tinazzi, M. (2008). Pain as a Nonmotor Symptom of Parkinson Disease: Evidence From a Case-Control Study. Arch Neurol 65: 1191-1194 [Abstract] [Full Text]  
• Jankovic, J (2008). Parkinson's disease: clinical features and diagnosis. J. Neurol. Neurosurg. Psychiatry 79: 368-376 [Abstract] [Full Text]  
• Schestatsky, P., Kumru, H., Valls-Sole, J., Valldeoriola, F., Marti, M. J., Tolosa, E., Chaves, M. L. (2007). Neurophysiologic study of central pain in patients with Parkinson disease. Neurology 69: 2162-2169 [Abstract] [Full Text]  
• Franca, M. C. Jr, D'Abreu, A., Friedman, J. H., Nucci, A., Lopes-Cendes, I. (2007). Chronic Pain in Machado-Joseph Disease: A Frequent and Disabling Symptom. Arch Neurol 64: 1767-1770 [Abstract] [Full Text]