Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
J Neurol. 2021 Dec;268(12):4759-4767. doi: 10.1007/s00415-021-10586-7. Epub 2021 May 15.
Pain is a common non-motor symptom in Parkinson's disease (PD), affecting up to 85% of patients. The frequency and stability of pain over time has not been extensively studied. There is a paucity of high-quality studies investigating pain management in PD. To develop interventions, an understanding of how pain changes over the disease course is required.
One hundred and fifty-four participants with early PD and 99 age-and-sex-matched controls were recruited as part of a longitudinal study (Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in PD, ICICLE-PD). Pain data were collected at 18-month intervals over 72 months in both groups using the Nonmotor Symptom Questionnaire (NMSQ), consisting of a binary yes/no response. Two questions from the Parkinson's Disease Questionnaire (PDQ-39) were analysed for the PD group only.
Unexplained pain was common in the PD group and occurred more frequently than in age-matched controls. 'Aches and pains' occurred more frequently than 'cramps and muscle spasms' at each time point (p < 0.001) except 54 months.
This study shows that pain is prevalent even in the early stages of PD, yet the frequency and type of pain fluctuates as symptoms progress. People with PD should be asked about their pain at clinical consultations and given support with describing pain given the different ways this can present.
疼痛是帕金森病（PD）的常见非运动症状，影响多达 85%的患者。疼痛的频率和稳定性随时间的变化尚未得到广泛研究。缺乏高质量的研究来调查 PD 中的疼痛管理。为了制定干预措施，需要了解疼痛在疾病过程中的变化情况。
154 名早期 PD 患者和 99 名年龄和性别匹配的对照者作为一项纵向研究（队列中认知障碍的发生率纵向评估在 PD 中，ICICLE-PD）的一部分被招募。在 72 个月的时间里，两组患者每隔 18 个月使用非运动症状问卷（NMSQ）收集疼痛数据，NMSQ 由一个二进制的是/否响应组成。PD 组仅分析了帕金森病问卷（PDQ-39）的两个问题。
未解释的疼痛在 PD 组中很常见，且比年龄匹配的对照组更频繁。除了 54 个月外，在每个时间点，“疼痛”比“痉挛和肌肉痉挛”更频繁地出现（p < 0.001）。
这项研究表明，即使在 PD 的早期阶段，疼痛也很常见，但随着症状的进展，疼痛的频率和类型会发生波动。在临床咨询中，应询问 PD 患者的疼痛情况，并给予他们描述疼痛的支持，因为疼痛可能有不同的表现方式。
