Pain in Parkinson disease: facts and uncertainties

BACKGROUND: Pain is one of the most common and troublesome non-motor symptoms of Parkinson's disease; it can appear at any time during the disease, and it is often present before diagnosis. However, there is little or no consensus on its definition. METHODS: An expert group of clinicians with relevant research experience met to review the existing evidence, and to identify gaps in our understanding towards an optimized therapy of pain in Parkinson's disease. RESULTS: Key findings from epidemiologic, neurophysiologic, neuroimaging and clinical studies are reviewed. In each case, the evidence base is limited by wide variations in the definitions of pain applied, study methodologies and populations evaluated. CONCLUSIONS: Disease-related as well as medical conditions trigger spontaneous pain in Parkinson patients which is then abnormally processed and results in painful manifestations in specific body parts. Dopaminergic medications like rotigotine as well as opiate analgesics like oxycodone have shown positive results but future studies with more detailed pain characterization at inclusion are warranted. This article is protected by copyright. All rights reserved.