title: Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study.
abstract: OBJECTIVE
  To determine whether pain is more frequent among people with Parkinson disease (PD) than among age-matched controls.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Logistic regression models taking into account type of pain, time between pain and PD onset, and possible confounders were used to compare 402 PD patients with 317 age-matched healthy control subjects.
  
  
  RESULTS
  The overall frequency of pain was significantly greater in PD patients than in controls (281 [69.9%] vs 199 [62.8%]; P = .04), mainly because the healthy control group lacked dystonic pain. Conversely, the frequency of nondystonic pain was similar among PD patients and controls (267 [66.4%] vs 199 [62.8%]; P = .28). Nevertheless, we observed a significant association between PD and nondystonic pain, beginning after the onset of parkinsonian symptoms (odds ratio, 2.1; 95% confidence interval, 1.4-2.9). Cramping and central neuropathic pain were more frequent among PD patients than controls. About one-quarter of patients who experienced pain reported pain onset before starting antiparkinsonian therapy.
  
  
  CONCLUSIONS
  These data support the hypothesis that pain begins at clinical onset of PD or thereafter as a nonmotor feature of PD.
authors.affiliation: Department of Neurology and Psychiatry, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy. gdefazio@neurol.uniba.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Defazio
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fabbrini
authors.forename: Davide
authors.initials: D
authors.lastname: Martino
authors.forename: Emiliana
authors.initials: E
authors.lastname: Fincati
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiaschi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Moretto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
authors.forename: Roberta
authors.initials: R
authors.lastname: Marchese
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Dotto
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.forename: Elisa
authors.initials: E
authors.lastname: De Vivo
authors.forename: Alberto
authors.initials: A
authors.lastname: Albanese
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lopiano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zibetti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
authors.forename: Emilia
authors.initials: E
authors.lastname: Martignoni
authors.forename: Paolo
authors.initials: P
authors.lastname: Lamberti
authors.forename: Michele
authors.initials: M
authors.lastname: Tinazzi
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*