title: Integrated Approach for Pain Management in Parkinson Disease.
abstract: Pain, one of the most frequent nonmotor symptoms of Parkinson disease (PD), is recognized as an important component of the illness that adversely affects patient quality of life. The aims of this review are to summarize the current knowledge on the clinical assessment and to provide a detailed overview of the evidence-based pharmacologic and nonpharmacologic approaches to treating pain. Results of a literature search include studies investigating pain/sensory abnormalities in PD. The effects of levodopa administration, deep brain stimulation (DBS), pallidotomy, spinal cord stimulation, rehabilitation, and complementary/alternative medicine are reviewed critically. PD patients have altered pain and sensory thresholds; levodopa and DBS improve pain and change sensory abnormalities toward normal levels through antinociceptive and/or modulatory effects that remain unknown. A wide range of nonpharmacologic approaches require further investigation. A multidisciplinary approach is fundamental in managing pain syndromes in PD.
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurological, Biomedical and Movement Sciences, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy. christian.geroin@univr.it.
authors.forename: Christian
authors.initials: C
authors.lastname: Geroin
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurological, Biomedical and Movement Sciences, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy. marialuisa.gandolfi@univr.it.|Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, P.le Scuro 10, 37134, Verona, Italy. marialuisa.gandolfi@univr.it.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Gandolfi
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada. veubru@gmail.com.
authors.forename: Veronica
authors.initials: V
authors.lastname: Bruno
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurological, Biomedical and Movement Sciences, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy. nicola.smania@univr.it.|Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, P.le Scuro 10, 37134, Verona, Italy. nicola.smania@univr.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
authors.affiliation: Neurology Unit, Movement Disorders Division, Department of Neurological, Biomedical and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy. michele.tinazzi@univr.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Tinazzi
mesh_terms: D000818:Animals; D046690:Deep Brain Stimulation / Q000379:methods; D006801:Humans; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy; D011788:Quality of Life; D062187:Spinal Cord Stimulation
keywords: Nonmotor symptoms; Pain; Pain management; Sensory thresholds