Pain in Neurodegenerative Disease: Current Knowledge and Future Perspectives.
Neurodegenerative diseases are going to increase as the life expectancy is getting longer. The management of neurodegenerative diseases such as Alzheimer's disease (AD) and other dementias, Parkinson's disease (PD) and PD related disorders, motor neuron diseases (MND), Huntington's disease (HD), spinocerebellar ataxia (SCA), and spinal muscular atrophy (SMA), is mainly addressed to motor and cognitive impairment, with special care to vital functions as breathing and feeding. Many of these patients complain of painful symptoms though their origin is variable, and their presence is frequently not considered in the treatment guidelines, leaving their management to the decision of the clinicians alone. However, studies focusing on pain frequency in such disorders suggest a high prevalence of pain in selected populations from 38 to 75% in AD, 40% to 86% in PD, and 19 to 85% in MND. The methods of pain assessment vary between studies so the type of pain has been rarely reported. However, a prevalent nonneuropathic origin of pain emerged for MND and PD. In AD, no data on pain features are available. No controlled therapeutic trials and guidelines are currently available. Given the relevance of pain in neurodegenerative disorders, the comprehensive understanding of mechanisms and predisposing factors, the application and validation of specific scales, and new specific therapeutic trials are needed.
Neurophysiopathology of Pain Section, SMBNOS Department, Bari Aldo Moro University, Bari, Italy.
Marina
M
de Tommaso
Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
Lars
L
Arendt-Nielsen
Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Ruth
R
Defrin
Department of General Practice, Section Gerontology, University Medical Center Groningen, Groningen, Netherlands.
Miriam
M
Kunz
CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Clermont-Ferrand, France; Inserm, CIC 1405, Neurodol 1107, 63003 Clermont-Ferrand, France.
Gisele
G
Pickering
Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark; Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.
Massimiliano
M
Valeriani
D006801:Humans; D019636:Neurodegenerative Diseases / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D059408:Pain Management / Q000379:methods* / Q000523:psychology