Rukavina Katarina, Staunton Juliet, Zinzalias Pavlos, Skoric Magdalena Krbot, Poplawska-Domaszewicz Karolina, Pisani Antonio, Bannister Kirsty, Chaudhuri K Ray
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. 2025 Feb;29(2):e4765. doi: 10.1002/ejp.4765.
Parkinson's disease (PD) is the second most common neurodegenerative disease. Over two thirds of People with Parkinson's (PwP) live with chronic PD-related pain, but its successful management remains an unmet need. Unrevealing links between pain and other motor and non-motor symptoms (NMS) of PD may accelerate delivery of much needed precision pain medicine approaches for PwP.
An exploratory, cross-sectional analysis of the prospective, observational, multicentre, international study 'The Non-motor International Longitudinal, Real-Life Study in PD - NILS'.
In 109 PwP (41.3% women, age 64.29 ± 9.80 years, disease duration 5.50 (2.44-10.89) years, H&Y stage 2 (1-4), levodopa equivalent daily dose 575.00 (315.00-1004.00) mg), strong correlations were noted between the total burden of PD-related pain and the total NMS burden (r = 0.641) and moderate with disturbances of sleep/fatigue (r = 0.483), cognitive issues (r = 0.445), motor complications (r = 0.421), anxiety (r = 0.441) and depression (r = 0.451). In a multivariate linear regression analysis, motor complications (B = 2.063, 95% CI for B 1.152-2.974, p < 0.001), sleep disturbances/fatigue (B = 0.392, 95% CI for B 0.064-0.720, p = 0.020) and anxiety (B = 0.912, 95% CI for B 0.165-1.659, p = 0.017) significantly impacted the overall burden of pain.
In PwP, PD-related pain is significantly impacted by motor complications, anxiety and sleep disturbances. A personalized, tailored approach to management of pain in PwP need to accurately identify and tackle all its interrelated symptoms. Whether successful management of motor complications, anxiety and sleep disturbances may contribute to pain relief in PwP for specified cohorts needs to be a focus of future randomized controlled clinical trials.
This explorative analysis identifies the frequent overlap of chronic pain, motor complications, sleep disturbances and anxiety in Parkinson's disease and could help advance the development of precise and effective pain management strategies tailored to the needs of People with Parkinson's.
帕金森病（PD）是第二常见的神经退行性疾病。超过三分之二的帕金森病患者（PwP）患有与帕金森病相关的慢性疼痛，但其有效管理仍是未满足的需求。揭示疼痛与帕金森病的其他运动和非运动症状（NMS）之间的联系，可能会加快为帕金森病患者提供急需的精准疼痛治疗方法。
对前瞻性、观察性、多中心、国际研究“帕金森病非运动国际纵向真实生活研究-NILS”进行探索性横断面分析。
在109名帕金森病患者中（41.3%为女性，年龄64.29±9.80岁，病程5.50（2.44 - 10.89）年，H&Y分期2（1 - 4），左旋多巴等效日剂量575.00（315.00 - 1004.00）mg），发现帕金森病相关疼痛的总负担与总NMS负担之间存在强相关性（r = 0.641），与睡眠/疲劳障碍（r = 0.483）、认知问题（r = 0.445）、运动并发症（r = 0.421）、焦虑（r = 0.441）和抑郁（r = 0.451）之间存在中度相关性。在多变量线性回归分析中，运动并发症（B = 2.063，B的95%置信区间为1.152 - 2.974，p < 0.001）、睡眠障碍/疲劳（B = 0.392，B的95%置信区间为0.064 - 0.720，p = 0.020）和焦虑（B = 0.912，B的95%置信区间为0.165 - 1.659，p = 0.017）对疼痛的总体负担有显著影响。
在帕金森病患者中，帕金森病相关疼痛受到运动并发症、焦虑和睡眠障碍的显著影响。针对帕金森病患者疼痛管理的个性化、量身定制方法需要准确识别并解决所有相关症状。对于特定队列的帕金森病患者，成功管理运动并发症、焦虑和睡眠障碍是否有助于缓解疼痛，需要成为未来随机对照临床试验的重点。
这项探索性分析确定了帕金森病中慢性疼痛、运动并发症、睡眠障碍和焦虑的频繁重叠，并有助于推进针对帕金森病患者需求的精准有效疼痛管理策略的开发。
