Section of Movement Disorders, Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Mov Disord. 2012 Apr;27(4):480-4. doi: 10.1002/mds.24054. Epub 2012 Jan 9.
Pain has been studied more intensely as a symptom of Parkinson's disease (PD) in recent years. However, studies on the characteristics and prevalence of pain in PD have yielded conflicting results, prompting us to do a systematic review of the literature. A systematic review of the literature was conducted, using different databases. The last inclusion date was March 15, 2011. The modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was used, which is especially designed for judging prevalence studies on their methodological quality. Only articles that met the predefined criteria were used in this review. We found 18 articles, of which only 8 met the methodological criteria. Prevalence frequency ranges from 40% to 85% with a mean of 67.6%. Pain is most frequently located in the lower limbs, with almost one-half of all PD patients complaining about musculoskeletal pain (46.4%). The pain fluctuates with on-off periods. Surprisingly, only 52.4% of PD patients with pain used analgesics, most often nonopioids. PD patients seem to be predisposed to develop pain and physicians should be aware of pain as a common feature of PD. As many as one-half of PD patients with pain may be missing out on a potentially useful treatment, and proper treatment could increase quality of life in PD patients.
近年来,疼痛作为帕金森病(PD)的一种症状受到了更深入的研究。然而,关于 PD 患者疼痛特征和发生率的研究结果却相互矛盾,促使我们对相关文献进行了系统综述。
我们采用不同的数据库进行了系统的文献检索,最后一次检索日期为 2011 年 3 月 15 日。我们使用了专门用于评估患病率研究方法学质量的改良诊断准确性研究质量评估工具(QUADAS)。只有符合既定标准的文章才被纳入本综述。
我们共发现 18 篇文章,其中仅有 8 篇符合方法学标准。疼痛的发生率范围为 40%至 85%,平均值为 67.6%。疼痛最常发生于下肢,几乎一半的 PD 患者(46.4%)诉说有肌肉骨骼疼痛。疼痛随开-关期波动。令人惊讶的是,仅有 52.4%的伴疼痛 PD 患者使用了镇痛药,其中大多数是非阿片类药物。PD 患者似乎容易发生疼痛,医生应该认识到疼痛是 PD 的一个常见特征。多达一半的伴疼痛 PD 患者可能错过了一种潜在有效的治疗方法,而适当的治疗可能会提高 PD 患者的生活质量。