Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
J Neurol Sci. 2018 Sep 15;392:3-7. doi: 10.1016/j.jns.2018.06.022. Epub 2018 Jun 25.
Pain is a frequent and debilitating non-motor symptom of Idiopathic Parkinson's Disease (IPD). The present study investigated the prevalence of pain and specifically peripheral neuropathic pain (PNP) in IPD, and ascertained any impact of PNP on quality of life (QoL).
Patients with IPD and age- and gender-matched controls were screened for overall pain using the King's Parkinson's Pain Scale (KPPS). PNP was assessed using the Michigan Neuropathy Screening Instrument (MNSI). QoL was assessed using the 36-Item Short Form Survey (SF-36).
Fifty-one patients and 51 age and gender matched controls were recruited. The prevalence of overall pain was similar in the two groups (88.2% versus 94.1%, p = 0.487). However, patients with IPD had higher KPPS scores in fluctuation-related (4.9 ± 6.9 vs 1.1 ± 2.6, p < 0.001), nocturnal (6.6 ± 7.5 vs 1.7 ± 4.2, p < 0.001) and oro-facial (0.6 ± 2.0 vs 0.0 ± 0.0, p = 0.040) domains compared to controls. Patients with IPD experienced more PNP compared to healthy control subjects (35.3% versus 13.7%, p = 0.011). After adjusting for age, gender, disease duration and overall KPSS score, PNP correlated negatively with physical functioning score (beta -0.290, p = 0.036), emotional role limitations score (beta -0.319, p = 0.032) and general health perception score (beta -0.342, p = 0.014) domains of SF-36.
Peripheral neuropathic pain is prevalent in IPD and has a significant impact on QoL. The presence of burning pain is suggestive of small fibre neuropathy, but this symptom is not featured in KPSS and, therefore, a revision of the KPSS should be considered.
疼痛是特发性帕金森病（IPD）常见且使人虚弱的非运动症状。本研究调查了 IPD 中疼痛的患病率，特别是周围神经性疼痛（PNP）的患病率，并确定了 PNP 对生活质量（QoL）的任何影响。
使用 King's Parkinson's Pain Scale（KPPS）对 IPD 患者和年龄、性别匹配的对照组进行总体疼痛筛查。使用密歇根州周围神经病变筛查工具（MNSI）评估 PNP。使用 36 项简短健康调查（SF-36）评估 QoL。
共纳入 51 例患者和 51 例年龄和性别匹配的对照组。两组的总体疼痛患病率相似（88.2%比 94.1%，p=0.487）。然而，与对照组相比，IPD 患者在波动相关（4.9±6.9 比 1.1±2.6，p<0.001）、夜间（6.6±7.5 比 1.7±4.2，p<0.001）和口面（0.6±2.0 比 0.0±0.0，p=0.040）领域的 KPPS 评分更高。与健康对照组相比，IPD 患者经历更多的 PNP（35.3%比 13.7%，p=0.011）。在调整年龄、性别、疾病持续时间和总体 KPSS 评分后，PNP 与生理功能评分（β-0.290，p=0.036）、情感角色限制评分（β-0.319，p=0.032）和 SF-36 的一般健康感知评分（β-0.342，p=0.014）呈负相关。
周围神经性疼痛在 IPD 中很常见，对 QoL 有显著影响。烧灼感提示小纤维神经病，但 KPSS 中没有这种症状，因此应考虑修订 KPSS。
