title: Is increased spinal nociception another hallmark for Parkinson's disease?
abstract: Augmented spinal nociception during the "off" phase has been observed early in Parkinson's disease further increasing with disease duration. To find out whether increased spinal nociception represents a premotor feature, experimental pain sensitivity was assessed in idiopathic REM-sleep behavior disorder (IRBD) patients with or without signs of a neurodegenerative disorder compared to early Parkinson's disease (ePD) patients and healthy controls (HC). Spinal nociception as measured by the nociceptive flexion reflex (NFR) and experimental pain sensitivity as measured by heat and electrical pain thresholds were determined in 14 IRBD, 15 ePD patients in the medication-defined "off" state and 27 HC in an explorative cohort study. No significant differences between IRBD and HC were found with regard to spinal nociception (NFR) and experimental pain sensitivity. However, IRBD patient with anosmia and/or abnormal DaTSCAN tended to increased experimental pain sensitivity. In contrast, early PD patients exhibited increased NFR responses compared to HC, and a tendency for increased spinal nociception compared to IRBD patients. Increased spinal nociception may represent an early but not a premotor, non-motor feature of PD. Whether increased pain sensitivity already presents a premotor feature should be assessed in further studies.
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Boura
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.|Second Department of Neurology, Movement Disorders Clinic, University of Athens and Movement Disorders Department, Hygeia Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Stamelou
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Vadasz
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ries
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.|Department of Neurology, Saarland University, Homburg, Germany.
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Unger
authors.affiliation: Department of Neurology, Kantonsspital St.Gallen, St. Gallen, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Kägi
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.|Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland.
authors.forename: Jens C
authors.initials: JC
authors.lastname: Möller
authors.affiliation: Department of Neurology, Philipps University, Baldingerstrasse, 35043, Marburg, Germany. mylius@med.uni-marburg.de.|Department of Neurology, Kantonsspital St.Gallen, St. Gallen, Switzerland. mylius@med.uni-marburg.de.|Department of Neurology, Center for Neurorehabilitation, Valens, Switzerland. mylius@med.uni-marburg.de.
authors.forename: Veit
authors.identifier: http://orcid.org/0000-0002-0900-0491
authors.initials: V
authors.lastname: Mylius
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004558:Electric Stimulation; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D059225:Nociception / Q000502:physiology; D059226:Nociceptive Pain / Q000503:physiopathology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D020187:REM Sleep Behavior Disorder / Q000150:complications / Q000503:physiopathology*; D013116:Spinal Cord / Q000503:physiopathology*
keywords: Nociceptive flexion reflex; Non-motor symptom; Pain sensitivity; Pain threshold; Parkinson’s disease; Premotor symptom; REM-sleep behavior disorder; Spinal nociception