title: Pain due to osteoarthritis may impair the early outcome of deep brain stimulation in Parkinson's disease.
abstract: OBJECTIVE
  To analyse postoperative pain due to osteoarthritis in patients with Parkinson's disease submitted to bilateral subthalamic nucleus stimulation.
  
  
  METHODS
  Fifty-three parkinsonian patients (mean age, 59.9 ± 8.3 years; mean disease duration, 11.5 ± 4.2 years) referred for subthalamic nucleus stimulation were enrolled. Patients were prospectively asked to refer and describe any pain due to osteoarthritis they experienced at any time during the preoperative period and within the 6 postoperative months. Pre-existing pain due to osteoarthritis, therapeutic changes, parkinsonian motor disability and weight gain were assessed as explanatory factors for occurrence pain due to osteoarthritis after surgery.
  
  
  RESULTS
  After surgery, thirty patients (57%) complained of pain due to osteoarthritis whereas all demonstrated great functional improvement. Twenty (67%) among the 30 experienced similar pain sensation before surgery. Symptoms occurred rapidly, between 4 and 26 postoperative weeks. Multiple stepwise regression analysis showed that pre-existing pain due to osteoarthritis, 6-month postoperative UPDRS III motor score and axial sub-score improvements in the off-drug/on-stimulation condition were accurate independent predictors of pain due to osteoarthritis after surgery (F(8,41)=2.20, p<0.047).
  
  
  CONCLUSIONS
  Our results highlight the high prevalence of pain due to osteoarthritis arising shortly after subthalamic implantation. An accurate pain and osteo-articular assessment should be performed preoperatively in parkinsonian candidates for subthalamic nucleus stimulation in order to limit occurrence of complications in the early postoperative period.
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, 76031 Rouen Cedex, France.
authors.forename: Solène
authors.initials: S
authors.lastname: Genty
authors.forename: Stéphane
authors.initials: S
authors.lastname: Derrey
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.forename: Romain
authors.initials: R
authors.lastname: Lefaucheur
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chastan
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gérardin
authors.forename: David
authors.initials: D
authors.lastname: Maltête
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications*; D010146:Pain / Q000209:etiology*; D010300:Parkinson Disease / Q000601:surgery / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D020531:Subthalamic Nucleus / Q000502:physiology; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology