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Pain in atypical parkinsonism, vascular parkinsonism, and Parkinson’s disease

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Abstract

Background

Pain is a common symptom in Parkinson’s disease (PD) and is considered a pre-motor symptom suggesting sensory involvement in the pre-motor stage. Pain in other parkinsonian disorders such as atypical parkinsonism and vascular parkinsonism (VP) has been investigated in only a few studies. The characteristics of pain in other parkinsonian disorders, including the temporal relationships between pain and motor symptoms, were investigated in the present study.

Methods

A total of 236 PD, 42 multiple system atrophy (MSA), 31 progressive supranuclear palsy (PSP), and 38 VP patients were screened for pain. After excluding patients with dementia and pain not related to PD, the presence of pain, severity, onset, type, and location were compared among the four patient groups.

Results

Difference was not observed in pain presence (χ2 = 3, p = 0.186), severity (F = 1.534, p = 0.207), or type (χ2 = 6, p = 0.400) among the four groups. However, the temporal relationship between pain and motor symptoms differed (H(3) = 8.764, p = 0.033). Pain predated motor symptoms in PD, MSA, and VP but often followed motor symptoms in PSP. The pain location in the body was different among the four patient groups (χ2 = 21, p = 0.018), and leg involvement was more common in PSP.

Conclusion

The present study results suggest that pain can be a pre-motor symptom in PD, MSA, and VP but not in PSP, implying different pain pathogeneses in these disorders. Pain locations were other for each group, which requires further investigation with a more extensive study cohort.

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Authors and Affiliations

  1. Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea

    Young Hee Sung

  2. Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong, Gyeonggi-do, 18450, Republic of Korea

    Suk Yun Kang

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Correspondence to Suk Yun Kang.

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This protocol was approved by our Institutional Review Board of Dongtan Sacred Heart Hospital. All methods were carried out in accordance with relevant guidelines and regulations. This study was performed in accordance with the Declaration of Helsinki. The study conducted in accordance with good clinical practice.

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Sung, Y.H., Kang, S.Y. Pain in atypical parkinsonism, vascular parkinsonism, and Parkinson’s disease. Neurol Sci 43, 4797–4802 (2022). https://doi.org/10.1007/s10072-022-06035-6

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