The Parkinson's disease pain classification system (PDPCS): results from an international mechanism-based classification approach

PEREZ LLORET, SANTIAGO (COMPARTE 1ERA POSICIÓN CON MYLIUS, VEIT); MYLIUS, VEIT; CURY, RUBENS G.; TEIXEIRA, MANOEL J.; BARBOSA, VICTOR R.; BARBOSA, EGBERTO R.; MOREIRA, LARISSA I.; LISTIK, CLARICE; FERNANDES, ANA M.; DE LACERDA VEIGA, DIOGO; BARBOUR, JULIO; HOLLENSTEIN, NATHALIE; OECHSNER, MATTHIAS; WALCH, JULIA; BRUGGER, FLORIAN; HÄGELE-LINK, STEFAN; BEER, SERAFIN; RIZOS, ALEXANDRA; CHAUDHURI, KALLOL RAY; BOUHASSIRA, DIDIER; LEFAUCHEUR, JEAN-PASCAL; TIMMERMANN, LARS; GONZENBACH, ROMAN; KÄGI, GEORG; MÖLLER, JENS CARSTEN; CIAMPI DE ANDRADE, DANIEL

PAIN

ELSEVIER SCIENCE BV

Lugar: Amsterdam; Año: 2020

0304-3959

Pain is a common non-motor symptom in patients with Parkinson´s disease (PD) but the correct diagnosis of the respective cause remains difficult because suitable tools are lacking, so far. We developed a framework to differentiate PD- from non-PD-related pain and classify PD-related pain into three groups based on validated mechanistic pain descriptors (nociceptive, neuropathic, or nociplastic), which encompass all the previously described PD pain types. Severity of PD-related pain syndromes was scored by ratings of intensity, frequency, and interference with daily living activities. The PD-Pain Classification System (PD-PCS) was compared with classic pain measures (ie, brief pain inventory (BPI) and McGill pain questionnaire (MPQ), PDQ-8 quality of life score, MDS-UPDRS scores, and non-motor symptoms). 159 non-demented PD patients (disease duration 10.2±7.6 years) and 37 healthy controls were recruited in four centers. PD-related pain was present in 122 patients (77%), with 24 (15%) suffering one or more syndromes at the same time. PD-related nociceptive, neuropathic, or nociplastic pain was diagnosed in 87 (55%), 25 (16%), or 35 (22%), respectively. Pain unrelated to PD was present in 35 (22%) patients. Overall, PD-PCS severity score significantly correlated with pain´s BPI and MPQ ratings, presence of dyskinesia and motor fluctuations, PDQ-8 scores, depression and anxiety measures. Moderate intra- and inter-rater reliability was observed. The PD-PCS is a valid and reliable tool for differentiating PD-related pain from PD-unrelated pain. It detects and scores mechanistic pain subtypes in a pragmatic and treatment-oriented approach, unifying previous classifications of PD-pain.