BACKGROUND AND PURPOSE: Reduced endogenous pain inhibition, as part of the degenerative process, is presumed to be the mechanism underlying the common presence of pain in patients with Parkinson's disease (PD). The present study aimed to assess an endogenous pain inhibitory system in PD using the conditioned pain modulation paradigm. METHODS: Twenty-six predominantly unilateral PD patients and 19 controls underwent psychophysical pain assessment before and after patients' morning dopaminergic medication. RESULTS: An unexpected increase in several parameters of pain perception for PD patients was found after dopaminergic medication (e.g. for 49°C noxious heat stimulation an increase from 70.6 ± 4.0 to 77.6 ± 4.0 on the numerical pain scale, P < 0.001). This increase was seen in patients with predominantly left-sided PD, regardless of the stimulated side (for 49°C noxious heat stimulation, predominantly left-sided PD patients, pain perception increased from 73.5 ± 6.8 to 85.0 ± 6.8, P < 0.001, whereas predominantly right-sided PD patients did not show a significant increase, 68.3 ± 6.8 to 70.4 ± 6.5, P = 0.777). Baseline efficiency of conditioned pain modulation inversely correlated with age at disease onset (r = -0.522; P = 0.009) and disease severity (Unified PD Rating Scale, r = 0.447; P = 0.032) but did not differ between patients and controls. CONCLUSIONS: Increased sensory response causing hyperalgesia occurs after dopaminergic medication in patients with predominantly left-sided PD.
BACKGROUND AND PURPOSE: Reduced endogenous pain inhibition, as part of the degenerative process, is presumed to be the mechanism underlying the common presence of pain in patients with Parkinson's disease (PD). The present study aimed to assess an endogenous pain inhibitory system in PD using the conditioned pain modulation paradigm. METHODS: Twenty-six predominantly unilateral PDpatients and 19 controls underwent psychophysical pain assessment before and after patients' morning dopaminergic medication. RESULTS: An unexpected increase in several parameters of pain perception for PDpatients was found after dopaminergic medication (e.g. for 49°C noxious heat stimulation an increase from 70.6 ± 4.0 to 77.6 ± 4.0 on the numerical pain scale, P < 0.001). This increase was seen in patients with predominantly left-sided PD, regardless of the stimulated side (for 49°C noxious heat stimulation, predominantly left-sided PDpatients, pain perception increased from 73.5 ± 6.8 to 85.0 ± 6.8, P < 0.001, whereas predominantly right-sided PDpatients did not show a significant increase, 68.3 ± 6.8 to 70.4 ± 6.5, P = 0.777). Baseline efficiency of conditioned pain modulation inversely correlated with age at disease onset (r = -0.522; P = 0.009) and disease severity (Unified PD Rating Scale, r = 0.447; P = 0.032) but did not differ between patients and controls. CONCLUSIONS: Increased sensory response causing hyperalgesia occurs after dopaminergic medication in patients with predominantly left-sided PD.
Authors: G C Nascimento; K Bariotto-Dos-Santos; C R A Leite-Panissi; E A Del-Bel; M Bortolanza Journal: Neurotox Res Date: 2018-04-02 Impact factor: 3.911
Authors: Santiago Perez-Lloret; Daniel Ciampi de Andrade; Kelly E Lyons; Carmen Rodríguez-Blázquez; Kallol Ray Chaudhuri; Guenther Deuschl; Girgio Cruccu; Cristina Sampaio; Christopher G Goetz; Anette Schrag; Pablo Martinez-Martin; Glenn Stebbins Journal: Mov Disord Clin Pract Date: 2016-06-24
Authors: Veit Mylius; Daniel Ciampi de Andrade; Rubens Gisbert Cury; Michael Teepker; Uwe Ehrt; Karla Maria Eggert; Serafin Beer; Jürg Kesselring; Maria Stamelou; Wolfgang H Oertel; Jens Carsten Möller; Jean-Pascal Lefaucheur Journal: Mov Disord Clin Pract Date: 2015-08-09