2025 American Academy of Neurology Abstract Website

Utsav Patel¹, Jeremiah H Wijaya², Made AM Inggas², Prakriti Arya³, Sanidhya S. Karve⁴, Tawfiq Turjman⁵, Hisham Turjman⁵, Muhammad Khalid⁶, Alan Kaye⁷, Saurabh Kataria⁸
¹Mayo Clinic, FL, USA, ²Siloam Hospital Lippo Village, Tangerang, Banten, Indonesia, ³Internal Medicine, Doctors Hospital at Renaissance, TX 78539, USA, ⁴Radiology, Amrita Institute Of Medical Sciences, Kochi, India, ⁵Royal College of Surgeons in Ireland Medical University of Bahrain: RCSI Bahrain, ⁶Neurology, ⁷Anesthesiology and Pain Medicine, ⁸Neurology and Pain Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport LA 71103, USA

Objective:

Identify the types of pain experienced by individuals with PD and beneficial treatment options.

Background:

Therapeutic modalities encompass a spectrum ranging from pharmacological interventions to surgical procedures such as deep brain stimulation (DBS). Reported success rates of these interventions in alleviating pain symptoms associated with Parkinson's Disease (PD) vary notably. There is a need to delve into real-world scenarios to comprehensively comprehend the prevalence of pain in PD, explore the breadth of available treatment modalities—both surgical and non-surgical—and discern factors that might predict more favorable responses to these interventions.

Design/Methods:

We systematically reviewed the features of pain in Parkinson's disease (PD) by searching databases like PubMed, Europe PMC, and SCOPUS until October 4, 2024, using the terms "Parkinson disease," "Parkinsonism," and "pain." We evaluated all selected studies for bias using the ROBINS-I tool and followed the PRISMA guideline for conducting the study.

Results:

Musculoskeletal pain predominates in PD constituting 40%— 90% of reported cases. It correlates with parkinsonian rigidity, akinesia, postural abnormalities, or dystonia, often accentuated on the side with prominent motor symptoms. Pain linked to akinesia may occur nocturnally, necessitating differentiation from restless leg syndrome. Approximately 4%—10% of PD patients experience pain directly attributed to the disease. Central Parkinson pain varies between intermittent and persistent, characterized by diffuse sensations like aching, burning, or cramping. Radicular pain prevalence in PD ranges from 14% to 35%, exceeding the general population's 10%.

Conclusions:

Through a deepened understanding of the occurrence and consequences of chronic pain in PD, alongside its ramifications on patient well-being, novel methodologies and strategies can be devised to enhance patient outcomes. By delving into biomarkers, we can explore predictive indicators to discern individuals who are likely to benefit from DBS for alleviating chronic pain symptoms. Additionally, this exploration can help identify those who may necessitate supplementary therapeutic interventions to achieve effective symptom relief.