Asymmetric pain processing in Parkinson%26apos;s disease

作者：Granovsky Y; Schlesinger I; Fadel S; Erikh I; Sprecher E; Yarnitsky D^*

来源：European Journal of Neurology, 2013, 20(10): 1375-1382.

DOI：10.1111/ene.12188

• conditioned pain modulation
• mesolimbic system
• pain
• Parkinson%26apos
• s disease

Background and purpose: Reduced endogenous pain inhibition, as part of the degenerative process, is presumed to be the mechanism underlying the common presence of pain in patients with Parkinson%26apos;s disease (PD). The present study aimed to assess an endogenous pain inhibitory system in PD using the conditioned pain modulation paradigm. %26lt;br%26gt;Methods: Twenty-six predominantly unilateral PD patients and 19 controls underwent psychophysical pain assessment before and after patients%26apos; morning dopaminergic medication. %26lt;br%26gt;Results: An unexpected increase in several parameters of pain perception for PD patients was found after dopaminergic medication (e.g. for 49 degrees C noxious heat stimulation an increase from 70.6 +/- 4.0 to 77.6 +/- 4.0 on the numerical pain scale, P %26lt; 0.001). This increase was seen in patients with predominantly left-sided PD, regardless of the stimulated side (for 49 degrees C noxious heat stimulation, predominantly left-sided PD patients, pain perception increased from 73.5 +/- 6.8 to 85.0 +/- 6.8, P %26lt; 0.001, whereas predominantly right-sided PD patients did not show a significant increase, 68.3 +/- 6.8 to 70.4 +/- 6.5, P = 0.777). Baseline efficiency of conditioned pain modulation inversely correlated with age at disease onset (r = -0.522; P = 0.009) and disease severity (Unified PD Rating Scale, r = 0.447; P = 0.032) but did not differ between patients and controls. %26lt;br%26gt;Conclusions: Increased sensory response causing hyperalgesia occurs after dopaminergic medication in patients with predominantly left-sided PD.

• 出版日期2013-10