Stoyanova-Piroth Galina, Milanov Ivan, Stambolieva Katerina
St. Naum Hospital of Neurology and Psychiatry, Medical University, Sofia, Bulgaria.
ZURZACH Care, Neurorehabilitation, Rehaklinik Baden Dättwil, Baden, Switzerland.
Front Neurol. 2024 Jul 25;15:1420696. doi: 10.3389/fneur.2024.1420696. eCollection 2024.
The neurodegenerative process in Parkinson's disease (PD) affects both dopaminergic and non-dopaminergic structures, which determine the wide range of motor and non-motor symptoms (NMS), including different types of pain. Diverse mechanisms contribute to pain in PD. Abnormal nociceptive processing is considered a distinctive feature of the disease.
In the present study, we used a validated PD-specific pain assessment tool to investigate self-reported pain in PD patients and to analyze the association with the objective pain threshold.
The RIII component of the nociceptive flexor reflex was assessed in 35 patients with PD and was compared to 40 healthy controls. Self-reported pain was measured using the Bulgarian version of the King's Parkinson's Disease Pain Scale (KPPS-BG). A correlation analysis was used to investigate the relationship between the objective nociceptive threshold and PD pain as assessed by KPPS-BG.
PD patients had a significantly lower RIII threshold than control individuals (the mean SD value was 6.24 ± 1.39 vs. 10.33 ± 1.64) when assessed in the "off" state. A statistically significant ( < 0.05) fairly negative Spearman's correlation was observed between the decreased spinal nociceptive threshold and fluctuation-related pain (-0.31). Domain 4, "nocturnal pain" (-0.21), and the KPPS-BG total score (-0.21) showed a weak negative correlation. An insignificant positive correlation was found between domain 6-"discoloration, edema/swelling"-and the RIII threshold. A higher Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score and modified Hoehn and Yahr (H&Y) scale are associated with a decreased nociceptive flexor reflex threshold.
The results of the present study demonstrate the important role of increased spinal nociception in the occurrence of pain, which is associated with fluctuations and, to a lesser extent, nocturnal pain.
帕金森病（PD）中的神经退行性过程会影响多巴胺能和非多巴胺能结构，这决定了广泛的运动和非运动症状（NMS），包括不同类型的疼痛。多种机制导致PD中的疼痛。异常的伤害性处理被认为是该疾病的一个显著特征。
在本研究中，我们使用经过验证的PD特异性疼痛评估工具来调查PD患者的自我报告疼痛，并分析其与客观疼痛阈值的关联。
对35例PD患者的伤害性屈肌反射的RIII成分进行评估，并与40名健康对照者进行比较。使用保加利亚语版的国王帕金森病疼痛量表（KPPS-BG）测量自我报告的疼痛。采用相关分析来研究由KPPS-BG评估的客观伤害性阈值与PD疼痛之间的关系。
在“关”状态下评估时，PD患者的RIII阈值明显低于对照个体（平均标准差分别为6.24±1.39和10.33±1.64）。在降低的脊髓伤害性阈值与波动相关疼痛（-0.31）之间观察到具有统计学意义（<0.05）的相当显著的负斯皮尔曼相关性。第4领域“夜间疼痛”（-0.21）和KPPS-BG总分（-0.21）显示出弱负相关性。在第6领域“变色、水肿/肿胀”与RIII阈值之间发现无显著正相关性。较高的运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第三部分评分和改良的 Hoehn 和 Yahr（H&Y）量表与降低的伤害性屈肌反射阈值相关。
本研究结果表明脊髓伤害性感受增强在疼痛发生中起重要作用，这与波动以及在较小程度上与夜间疼痛相关。
