Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK.
Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK.
Eur J Pain. 2024 Feb;28(2):244-251. doi: 10.1002/ejp.2172. Epub 2023 Aug 16.
Musculoskeletal (MSK) pain affects over 80% of People with Parkinson's (PD, PwP) and may, in part, be dopaminergic in origin, as dopaminergic medication often leads to its relief.
PwP who underwent striatal dopamine transporter visualization with a radiopharmaceutical DaTscan™ ( I-Ioflupane Injection) using a single-photon emission computed tomography (SPECT) as a part of their clinical-diagnostic work up were enrolled in the "Non-motor International Longitudinal Study" (NILS; UK National Institute for Health Research Clinical Research Network Number 10084) and included in this cross-sectional analysis. The association between specific DaTscan binding ratios for each striatum, the caudate nucleus and putamen and clinical ratings for MSK pain (assessed using the King's Parkinson's Disease Pain Scale (KPPS)) were analysed.
53 PwP (30.2% female; age: 63.79 ± 11.31 years; disease duration (DD): 3.32 (0.31-14.41) years; Hoehn & Yahr stage (H&Y): 2 (1-4); Levodopa Equivalent Daily Dose (LEDD): 543.08 ± 308.94 mg) were assessed and included in this analysis. MSK pain was highly prevalent (71.7% of all participants, mean KPPS Item 1 score 5.34 ± 4.76) and did not correlate with the motor symptoms burden (SCOPA-Motor total score; p = 0.783) but showed a significant correlation with quality of life (PDQ-8, r = 0.290, p = 0.035). z-scores for the caudate nucleus (Exp (B) = 0.367, 95% CI for Exp (B) 0.148-0.910, p = 0.031) and striatum (Exp (B) = 0.338, 95% CI for Exp (B) 0.123-0.931, p = 0.036), adjusted for DD, H&Y and LEDD, were significant determinants of MSK pain.
Our findings suggest an association between MSK pain in PwP and the severity of dopaminergic deficiency in the caudate nucleus.
In People with Parkinson's, musculoskeletal pain does not arise simply as a direct sequel to motor symptoms-instead, it is linked to the severity of dopaminergic depletion in the caudate nucleus.
肌肉骨骼（MSK）疼痛影响超过 80%的帕金森病患者（PD，PwP），部分可能与多巴胺能有关，因为多巴胺能药物通常会缓解疼痛。
接受放射性药物 DaTscan™（I-碘代苯丙胺注射液）进行纹状体多巴胺转运蛋白可视化的 PwP 作为其临床诊断工作的一部分进行了单光子发射计算机断层扫描（SPECT），并被纳入“非运动国际纵向研究”（NILS；英国国家卫生研究院临床研究网络编号 10084），并包括在这项横断面分析中。分析了每个纹状体、尾状核和壳核的特定 DaTscan 结合比率与肌肉骨骼疼痛的临床评分（使用 King's Parkinson's Disease Pain Scale（KPPS）进行评估）之间的关联。
53 名 PwP（30.2%为女性；年龄：63.79±11.31 岁；疾病持续时间（DD）：3.32（0.31-14.41）年；Hoehn & Yahr 分期（H&Y）：2（1-4）；左旋多巴等效每日剂量（LEDD）：543.08±308.94mg）接受了评估并纳入了这项分析。肌肉骨骼疼痛的患病率很高（所有参与者中有 71.7%，平均 KPPS 项目 1 评分 5.34±4.76），与运动症状负担无关（SCOPA-Motor 总分；p=0.783），但与生活质量显著相关（PDQ-8，r=0.290，p=0.035）。尾状核（Exp（B）=0.367，95%CI for Exp（B）0.148-0.910，p=0.031）和纹状体（Exp（B）=0.338，95%CI for Exp（B）0.123-0.931，p=0.036）的 z 分数，调整 DD、H&Y 和 LEDD 后，是肌肉骨骼疼痛的显著决定因素。
我们的研究结果表明，帕金森病患者的肌肉骨骼疼痛与尾状核多巴胺能缺乏的严重程度有关。
在帕金森病患者中，肌肉骨骼疼痛并不是单纯由运动症状直接引起的，而是与尾状核多巴胺能缺失的严重程度有关。
