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Levodopa raises objective pain threshold in Parkinson’s disease: A RIII reflex study
  1. A Gerdelat-Mas (gerdelat-mas.a{at}chu-toulouse.fr)
  1. Hôpital Purpan, France
    1. M Simonetta-Moreau (simonetta.m{at}chu-toulouse.fr)
    1. Hôpital Purpan, INSERM U825, Université Paul Sabatier III, France
      1. C Thalamas (cic9302{at}toulouse.inserm.fr)
      1. CIC 9302, INSERM U825, Université Paul Sabatier III, France
        1. F Ory-Magne (ory.f{at}chu-toulouse.fr)
        1. Hôpital Purpan, France
          1. T Slaoui (slaoui.t{at}chu-toulouse.fr)
          1. Hôpital Purpan, France
            1. O Rascol (rascol{at}cict.fr)
            1. Hôpital Purpan, CIC 9302, INSERM U825, Université Paul Sabatier III, France
              1. C Brefel-Courbon (brefel{at}cict.fr)
              1. Hôpital Purpan, INSERM U825, Université Paul Sabatier III, France

                Abstract

                Background: Patients suffering from Parkinson’s disease (PD) describe painful sensations that could be related to neuropathic pain. Experimental data have indicated the involvement of basal ganglia and dopaminergic pathways in central nociceptive processing.

                Aim: The objective of this study was to assess and to compare the effect of levodopa on the objective pain threshold in PD patients and healthy subjects.

                Methods: The objective pain threshold was assessed by the nociceptive flexion reflex (RIII) in 13 PD patients and 10 healthy subjects. Patients and healthy subjects were evaluated in two randomized conditions: with levodopa (ON) and without (OFF). Results: Levodopa significantly increased the RIII threshold of PD patients (6.9 ± 1.2 mA in OFF condition versus 8 ± 1.1 mA in ON p=0.02). RIII threshold was significantly lower in PD patients than in healthy subjects in OFF condition (6.9 ± 1.2 mA versus 9.7 ± 3.4 mA p=0.02). RIII threshold did not change after levodopa administration in healthy subjects.

                Conclusion: These results provide evidence of a dopaminergic modulation of objective pain threshold in PD patients. In addition, the decrease of RIII threshold in PD patients, in OFF condition, compared to controls confirms the existence of an objective pain perception disturbance in Parkinson’s disease.

                • levodopa
                • pain threshold
                • parkinson’ disease
                • rIII reflex

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