Department of Neurology, Palacky University Medical School, University Hospital, Olomouc, Czech Republic.
J Neurol Sci. 2012 Aug 15;319(1-2):102-4. doi: 10.1016/j.jns.2012.05.002. Epub 2012 May 30.
The purpose of this study was to review the prevalence of musculoskeletal pain in the prodromal phase of PD, before the PD diagnosis is made.
A retrospective review of 82 PD patients was performed. Hospital inpatient notes and outpatient clinic admission notes were reviewed. The initial complaints prompting patients to seek medical attention were noted, as were the initial diagnoses. The symptoms were considered retrospectively to be associated with PD.
Musculoskeletal pain was present as a prodromal PD symptom in 27 (33%) cases initially diagnosed with osteoarthritis, degenerative spinal disease, and frozen shoulder. The mean time from the initial symptom appearance to dopaminergic treatment was 6.6 years in the musculoskeletal pain group and 2.3 years in the group with typical PD signs. Significant improvement of musculoskeletal pain after the initiation of dopaminergic treatment was present in 23 (85%) cases.
Of the PD patients who went on to develop motor features of PD, one third manifested musculoskeletal pain as the initial symptom. A good response to L-DOPA therapy was seen in 85% of cases presenting with musculoskeletal pain. Our findings suggest that musculoskeletal pain may be a significant feature in earlier PD stages.
本研究旨在回顾 PD 前驱期（即在 PD 诊断之前）肌肉骨骼疼痛的患病率。
对 82 例 PD 患者进行了回顾性研究。查阅了住院病历和门诊入院记录。记录了促使患者寻求医疗的初始主诉，以及初始诊断。回顾性地认为这些症状与 PD 有关。
最初诊断为骨关节炎、退行性脊柱疾病和冻结肩的 27 例（33%）患者出现肌肉骨骼疼痛，作为 PD 的前驱症状。在肌肉骨骼疼痛组中，从最初症状出现到给予多巴胺能治疗的平均时间为 6.6 年，而在具有典型 PD 体征的组中为 2.3 年。23 例（85%）患者在开始多巴胺能治疗后肌肉骨骼疼痛显著改善。
在进展为 PD 运动特征的患者中，有三分之一以肌肉骨骼疼痛为初始症状。85%出现肌肉骨骼疼痛的患者对 L-DOPA 治疗有良好反应。我们的研究结果表明，肌肉骨骼疼痛可能是 PD 早期的一个重要特征。
