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Is increased spinal nociception another hallmark for Parkinson’s disease?

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Abstract

Augmented spinal nociception during the “off” phase has been observed early in Parkinson’s disease further increasing with disease duration. To find out whether increased spinal nociception represents a premotor feature, experimental pain sensitivity was assessed in idiopathic REM-sleep behavior disorder (IRBD) patients with or without signs of a neurodegenerative disorder compared to early Parkinson’s disease (ePD) patients and healthy controls (HC). Spinal nociception as measured by the nociceptive flexion reflex (NFR) and experimental pain sensitivity as measured by heat and electrical pain thresholds were determined in 14 IRBD, 15 ePD patients in the medication-defined “off” state and 27 HC in an explorative cohort study. No significant differences between IRBD and HC were found with regard to spinal nociception (NFR) and experimental pain sensitivity. However, IRBD patient with anosmia and/or abnormal DaTSCAN tended to increased experimental pain sensitivity. In contrast, early PD patients exhibited increased NFR responses compared to HC, and a tendency for increased spinal nociception compared to IRBD patients. Increased spinal nociception may represent an early but not a premotor, non-motor feature of PD. Whether increased pain sensitivity already presents a premotor feature should be assessed in further studies.

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Author notes

    Authors and Affiliations

    1. Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany

      Evangelia Boura, Maria Stamelou, David Vadasz, Vincent Ries, Marcus M. Unger, Wolfgang H. Oertel, Jens C. Möller & Veit Mylius

    2. Second Department of Neurology, Movement Disorders Clinic, University of Athens and Movement Disorders Department, Hygeia Hospital, Athens, Greece

      Maria Stamelou

    3. Department of Neurology, Saarland University, Homburg, Germany

      Marcus M. Unger

    4. Department of Neurology, Kantonsspital St.Gallen, St. Gallen, Switzerland

      Georg Kägi & Veit Mylius

    5. Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland

      Jens C. Möller

    6. Department of Neurology, Center for Neurorehabilitation, Valens, Switzerland

      Veit Mylius

    Authors
    1. Evangelia Boura
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    2. Maria Stamelou
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    3. David Vadasz
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    4. Vincent Ries
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    5. Marcus M. Unger
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    7. Wolfgang H. Oertel
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    8. Jens C. Möller
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    9. Veit Mylius
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    Correspondence to Veit Mylius.

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    On behalf of all authors, the corresponding author states that there is no conflict of interest.

    Ethical standards

    The authors declare that they acted in accordance with the ethical standards in the 2013 version of the 1964 Declaration of Helsinki.

    Funding

    E. Boura received a grant from the Hellenic Neurological Society and W.H. Oertel is Hertie-Senior Research Professor—supported by the Charitable Hertie Foundation Frankfurt/Main, Germany.

    Additional information

    E. Boura and M. Stamelou contributed equally to this work.

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    Boura, E., Stamelou, M., Vadasz, D. et al. Is increased spinal nociception another hallmark for Parkinson’s disease?. J Neurol 264, 570–575 (2017). https://doi.org/10.1007/s00415-016-8390-y

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    • DOI: https://doi.org/10.1007/s00415-016-8390-y

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