Chen Yi, Mao Cheng-Jie, Li Si-Jiao, Wang Fen, Chen Jing, Zhang Hui-Jun, Li Ling, Guo Sha-Sha, Yang Ya-Ping, Liu Chun-Feng
Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China; Institute of Neuroscience, Soochow University, Suzhou 215123, China.
Parkinsonism Relat Disord. 2015 Apr;21(4):361-5. doi: 10.1016/j.parkreldis.2015.01.008. Epub 2015 Jan 17.
Pain and sensory disturbances affect many patients with Parkinson's disease (PD). The present study aimed to evaluate the pain and sensory sensitivity of each class of afferent fibers in PD patients and determine the effects of dopaminergic therapy on pain and sensory sensitivity.
Current perception threshold (CPT) and pain tolerance thresholds (PTT) at three frequencies, 2000 Hz, 250 Hz, and 5 Hz, to stimulate Aβ fibers, Aδ fibers, and small C-polymodal fibers, respectively, were measured in 72 PD patients and 35 healthy controls.
CPT was higher at all three frequencies and PTT was lower at 2000 Hz and 250 Hz in PD patients with pain versus healthy controls (P < 0.05). CPT was higher at 2000 Hz and 250 Hz and PTT was lower at 2000 Hz and 250 Hz in PD patients without pain versus healthy controls (P < 0.05). PD patients with pain exhibited higher CPT at 5 Hz and 250 Hz than PD patients without pain (P < 0.05). Dopaminergic therapy did not affect CPT or PPT in PD patients (P > 0.05).
Abnormal Aδ fiber- and Aβ fiber-dependent sensory inputs may exist in PD. Abnormal sensory inputs via C fibers and Aδ fibers might be associated with the presence of pain in PD. Because dopaminergic therapy failed to mitigate these sensory and pain dysfunctions, mechanisms not involving the dopaminergic pathway are likely to be implicated.
疼痛和感觉障碍影响许多帕金森病（PD）患者。本研究旨在评估PD患者各类传入纤维的疼痛和感觉敏感性，并确定多巴胺能治疗对疼痛和感觉敏感性的影响。
在72例PD患者和35名健康对照者中，分别测量了2000Hz、250Hz和5Hz三个频率下的电流感觉阈值（CPT）和疼痛耐受阈值（PTT），以分别刺激Aβ纤维、Aδ纤维和小C多模式纤维。
与健康对照相比，有疼痛的PD患者在所有三个频率下的CPT均较高，在2000Hz和250Hz时的PTT较低（P<0.05）。与健康对照相比，无疼痛的PD患者在2000Hz和250Hz时的CPT较高，在2000Hz和250Hz时的PTT较低（P<0.05）。有疼痛的PD患者在5Hz和250Hz时的CPT高于无疼痛的PD患者（P<0.05）。多巴胺能治疗对PD患者的CPT或PPT无影响（P>0.05）。
PD患者可能存在异常的Aδ纤维和Aβ纤维依赖性感觉输入。通过C纤维和Aδ纤维的异常感觉输入可能与PD患者疼痛的存在有关。由于多巴胺能治疗未能减轻这些感觉和疼痛功能障碍，可能涉及不包括多巴胺能通路的机制。
