Open AccessThe Parkinson disease pain classification system: results from an international mechanism-based classification approach
Author(s) -
Veit Mylius,
Santiago Pérez Lloret,
Rubens Gisbert Cury,
Manoel Jacobsen Teixeira,
Victor R Barbosa,
Egberto Reis Barbosa,
Larissa Iulle Moreira,
Clarice Listik,
Ana Mércia Fernandes,
Diogo de Lacerda Veiga,
Julio Barbour,
Nathalie Hollenstein,
Matthias Oechsner,
Julia Walch,
Florian Brugger,
Stefan Hägele-Link,
Serafin Beer,
Alexandra Rizos,
K. Ray Chaudhuri,
Didier Bouhassira,
JeanPascal Lefaucheur,
Lars Timmermann,
Roman Gonzenbach,
Georg Kägi,
Jens Carsten Möller,
Daniel Ciampi de Andrade
Publication year - 2020
Publication title -
pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.524
H-Index - 258
eISSN - 1872-6623
pISSN - 0304-3959
DOI - 10.1097/j.pain.0000000000002107
Subject(s) - neuropathic pain , mcgill pain questionnaire , brief pain inventory , medicine , parkinson's disease , disease , physical therapy , nociception , anxiety , chronic pain , anesthesia , psychiatry , visual analogue scale , receptor
Pain is a common nonmotor symptom in patients with Parkinson 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 3 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 and McGill pain questionnaire [MPQ], PDQ-8 quality of life score, MDS-UPDRS scores, and nonmotor symptoms). 159 nondemented PD patients (disease duration 10.2 ± 7.6 years) and 37 healthy controls were recruited in 4 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 Brief Pain Inventory and MPQ ratings, presence of dyskinesia and motor fluctuations, PDQ-8 scores, depression, and anxiety measures. Moderate intrarater and interrater 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.