Beiske A G, Loge J H, Rønningen A, Svensson E
Department of Neurology, Akershus University Hospital, N-1478 Lørenskog, Norway.
Pain. 2009 Jan;141(1-2):173-7. doi: 10.1016/j.pain.2008.12.004. Epub 2008 Dec 18.
Parkinson's disease is a chronic, progressive, incurable neurodegenerative disease. As the disease progresses, motor disturbances and non-motor symptoms represent considerable illness burdens. Symptom relief is the goal for the treatment. Pain is frequently observed in patients with Parkinson's disease, but its prevalence, characteristics and associations with Parkinson's disease are poorly documented. These were investigated in 176 home-living PD patients. They underwent a neurological examination and a structured interview for registration of pain characteristics in addition to responding to standardised questionnaires. Pain was reported by 146 (83%) patients. Compared to the general population, the Parkinson's disease patients experienced significantly more pain as measured by SF-36 Bodily Pain Scale. The average pain during the last 24h measured by the Brief Pain Inventory was 2.85. Fifty-three percent of the patients reported one, 24% reported two and 5% reported three pain types. Musculoskeletal pain was reported by 70%, dystonic pain by 40%, radicular-neuropathic pain by 20% and central neuropathic pain by 10%. Thirty-four percent were on analgesic medication. Pain was not associated with age, disease duration or severity of the disease; female gender was the only significant predictor of pain. Pain is frequent and disabling, independent of demographic and clinical variables except for female gender, and is significantly more common in Parkinson's patients compared to the general population. A minority of the Parkinson's disease patients with pain received analgesic medication. The findings call for improved attention to assessment and treatment of pain in the follow-up of Parkinson's disease patients.
帕金森病是一种慢性、进行性、无法治愈的神经退行性疾病。随着疾病进展，运动障碍和非运动症状带来了相当大的疾病负担。缓解症状是治疗的目标。疼痛在帕金森病患者中很常见，但其患病率、特征以及与帕金森病的关联却鲜有文献记载。对176名居家生活的帕金森病患者进行了相关调查。他们除了回答标准化问卷外，还接受了神经学检查和关于疼痛特征登记的结构化访谈。146名（83%）患者报告有疼痛。与普通人群相比，通过SF-36身体疼痛量表测量，帕金森病患者经历的疼痛明显更多。通过简明疼痛量表测量，过去24小时内的平均疼痛评分为2.85。53%的患者报告有一种疼痛类型，24%报告有两种，5%报告有三种。70%的患者报告有肌肉骨骼疼痛，40%有肌张力障碍性疼痛，20%有神经根性神经病理性疼痛，10%有中枢性神经病理性疼痛。34%的患者正在服用止痛药物。疼痛与年龄、病程或疾病严重程度无关；女性是疼痛的唯一显著预测因素。疼痛很常见且会导致功能障碍，除女性外与人口统计学和临床变量无关，并且与普通人群相比在帕金森病患者中明显更常见。少数有疼痛的帕金森病患者接受了止痛药物治疗。这些发现呼吁在帕金森病患者的随访中更好地关注疼痛的评估和治疗。
