Hanagasi Hasmet A, Akat Sinem, Gurvit Hakan, Yazici Jale, Emre Murat
Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, Turkey.
Clin Neurol Neurosurg. 2011 Jan;113(1):11-3. doi: 10.1016/j.clineuro.2010.07.024. Epub 2010 Aug 25.
Patients with Parkinson's disease may present with severe or intractable pain, which can be more distressing than the motor disability. The aim of this prospective study was to assess the prevalence of pain and underlying causes in patients with idiopathic Parkinson's disease.
Ninety-six patients (42 female, 54 men) were interviewed and pain was assessed using patient descriptions, Visual Analog Scale (VAS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). Stait Trait Anxiety Inventory (STAI-TX 1 and 2) and Beck Depression Scale were also administered.
Pain as the first symptom of PD was seen in 3 patients (2.8%), 63 (64.9%) out of 96 patients reported pain. Pain types included musculoskeletal type of different etiologies (28 patients, 44.4%), radicular or neuropathic pain (7 patients, 11.1%), pain secondary to dystonia (12 patients, 19.1%) and central pain (8 patients, 12.7%). Eight patients (12.7%) described more than one type of pain. Pain did not correlate with sex, duration of disease, disease stage, use of dopamine agonists and levodopa, years of levodopa treatment and current levodopa dosage, depression, anxiety, sleep disturbances, age at onset of PD or history of disease in first-degree relatives. Akathisia seemed to be correlated with presence of pain (p<0.02).
Our results suggest that pain is one of the most common non-motor symptoms in patients with PD. In order to identify the appropriate treatment strategy, it is essential to identify the underlying etiology.
帕金森病患者可能出现严重或顽固性疼痛，这种疼痛可能比运动功能障碍更令人痛苦。这项前瞻性研究的目的是评估特发性帕金森病患者疼痛的患病率及潜在病因。
对96例患者（42例女性，54例男性）进行了访谈，并使用患者描述、视觉模拟量表（VAS）和利兹神经病理性症状与体征评估量表（LANSS）对疼痛进行评估。还进行了状态特质焦虑量表（STAI-TX 1和2）及贝克抑郁量表评估。
3例患者（2.8%）以疼痛作为帕金森病的首发症状，96例患者中有63例（64.9%）报告有疼痛。疼痛类型包括不同病因的肌肉骨骼型（28例患者，44.4%）、神经根性或神经病理性疼痛（7例患者，11.1%）、肌张力障碍继发疼痛（12例患者，19.1%）和中枢性疼痛（8例患者，12.7%）。8例患者（12.7%）描述了不止一种类型的疼痛。疼痛与性别、病程、疾病分期、多巴胺激动剂和左旋多巴的使用、左旋多巴治疗年限和当前左旋多巴剂量、抑郁、焦虑、睡眠障碍、帕金森病发病年龄或一级亲属疾病史均无相关性。静坐不能似乎与疼痛的存在相关（p<0.02）。
我们的结果表明，疼痛是帕金森病患者最常见的非运动症状之一。为了确定合适的治疗策略，识别潜在病因至关重要。
