Mylius Veit, Ciampi de Andrade Daniel, Cury Rubens Gisbert, Teepker Michael, Ehrt Uwe, Eggert Karla Maria, Beer Serafin, Kesselring Jürg, Stamelou Maria, Oertel Wolfgang H, Möller Jens Carsten, Lefaucheur Jean-Pascal
Department of Neurology Philipps University Marburg Germany.
Department of Neurology Center for Neurorehabilitation Valens Switzerland.
Mov Disord Clin Pract. 2015 Aug 9;2(4):357-364. doi: 10.1002/mdc3.12217. eCollection 2015 Dec.
Pain is a significant burden for patients with Parkinson's disease (PD) with a high impact on quality of life. The present article aims at summarizing epidemiological, pathophysiological, clinical, and neurophysiological data regarding pain in PD.
In this domain, a procedure of systematic assessment is still lacking for the syndromic diagnosis and should take into account pain characteristics, effects of dopaminergic treatment, motor fluctuations, and non-PD-associated pain.
We propose an original questionnaire addressing an algorithm suitable for daily clinical practice. The questionnaire is based on a three-step approach addressing first the relationship between pain and PD (including temporal relationship with the course of the disease, association with motor fluctuations, and impact of antiparkinsonian treatment), before classifying pain into one of three main syndromes (i.e., musculoskeletal pain, psychomotor restlessness pain, and neuropathic pain).
The proposed questionnaire allows the characteristics of each pain type to be determined according to its relationship with the disease and its treatment. The validation of the clinical use of this questionnaire will be the goal of a forthcoming work.
疼痛是帕金森病（PD）患者的一项重大负担，对生活质量有很大影响。本文旨在总结有关PD疼痛的流行病学、病理生理学、临床和神经生理学数据。
在该领域，综合征诊断仍缺乏系统评估程序，应考虑疼痛特征、多巴胺能治疗效果、运动波动以及与PD无关的疼痛。
我们提出了一份适用于日常临床实践的算法的原创问卷。该问卷基于三步法，首先解决疼痛与PD之间的关系（包括与疾病病程的时间关系、与运动波动的关联以及抗帕金森治疗的影响），然后将疼痛分类为三种主要综合征之一（即肌肉骨骼疼痛、精神运动性不安疼痛和神经性疼痛）。
所提出的问卷能够根据每种疼痛类型与疾病及其治疗的关系来确定其特征。该问卷临床应用的验证将是未来一项工作的目标。
