Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study.
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.
Defazio
Giovanni
G
Department of Neurology and Psychiatry, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy. gdefazio@neurol.uniba.it
Berardelli
Alfredo
A
Fabbrini
Giovanni
G
Martino
Davide
D
Fincati
Emiliana
E
Fiaschi
Antonio
A
Moretto
Giuseppe
G
Abbruzzese
Giovanni
G
Marchese
Roberta
R
Bonuccelli
Ubaldo
U
Del Dotto
Paolo
P
Barone
Paolo
P
De Vivo
Elisa
E
Albanese
Alberto
A
Antonini
Angelo
A
Canesi
Margherita
M
Lopiano
Leonardo
L
Zibetti
Maurizio
M
Nappi
Giuseppe
G
Martignoni
Emilia
E
Lamberti
Paolo
P
Tinazzi
Michele
M
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*