Pain sensitivity and descending inhibition of pain in Parkinson's disease

Mylius, V.; Engau, I.; Teepker, M.; Stiasny-Kolster, K.; Schepelmann, K.; Oertel, W. H.; Lautenbacher, S.; Möller, J. C.
January 2009
Journal of Neurology, Neurosurgery & Psychiatry;Jan2009, Vol. 80 Issue 1, p24
Academic Journal
Background: Patients suffering from Parkinson's disease (PD) often complain about painful sensations. Recent studies detected increased subjective pain sensitivity and increased spinal nociception, which appeared to be reversible by dopaminergic treatment. Possibly, reduced descending pain inhibition contributes to this finding. Objective: Subjective pain thresholds as well as nociceptive reflex thresholds were investigated to isolate potential loci of the pathophysiological changes within the pain pathway. In addition, the diffuse noxious inhibitory control (DNIC) system as one form of descending control was assessed. Method: 15 patients with PD and 18 controls participated in the study. Electrical and heat pain thresholds as well as the nociceptive flexion reflex (NFR) thresholds were determined. Thereafter, the electrical pain thresholds were measured once during painful heat stimulation (conditioning stimulation) and twice during innocuous stimulation (control stimulation). Results: Patients with PD exhibited lower electrical and heat pain thresholds as well as lower NFR thresholds. Suppression of the electrical pain thresholds during painful heat stimulation (conditioning stimulation) compared with control stimulation did not differ significantly between the groups. No differences in the thresholds between patients with PD with and without clinical pain were seen. Conclusions: Finding the NFR threshold to be decreased in addition to the decreased electrical and heat pain thresholds indicates that the pathophysiological changes either already reside at or reach down to the spinal level. Reduced activation of the DNIC system was apparently not associated with increased pain sensitivity, suggesting that DNIC-like mechanisms do not significantly contribute to clinical pain in PD.


Related Articles

  • Caring for patients with Parkinson's disease. Doherty, Jane; Lyle, Nerolie // Australian Nursing Journal;Mar2004, Vol. 11 Issue 8, Special Section p23 

    Discusses the appropriate care for patients with Parkinson's disease. Theories on causation and symptoms of the disease; Nursing guidelines for communicating with Parkinson's patients; Management of neuro-psychiatric challenges.

  • Laser Pointer Unfreezes Parkinson's Symptoms. Walsh, Teri // Prevention;Feb2001, Vol. 53 Issue 2, p174 

    Reports that handheld laser pointers may help people with Parkinson's disease to avoid sudden freezing episodes which leave them temporarily unable to move.

  • Deep-Brain Stimulation for Depression. Glannon, Walter // HEC Forum;Dec2008, Vol. 20 Issue 4, p325 

    The article reports on deep-brain stimulation for depression (DBS) technique. It states that DBS holds considerable therapeutic promise for the treatment of a range of neuropsychiatric disorders. The technique has been used mainly to modulate activity in subcortical regions of the brain in...

  • Continuous apomorphine infusion and neuropsychiatric disorders: a controlled study in patients with advanced Parkinson's disease. Di Rosa, A. E.; Epifanio, A.; Antonini, A.; Stocchi, F.; Martino, G.; Di Blasi, L.; Tetto, A.; Basile, G.; Imbesi, D.; La Spina, P.; Di Raimondo, G.; Morgante, L. // Neurological Sciences;Oct2003, Vol. 24 Issue 3, p174 

    The aim of this study was to asses whether patients with Parkinson's disease (PD) develop cognitive and psychiatric complications more frequently during pro- longed therapy with continuous apomorphine infusion compared with standard oral treatment. Thirty consecutive PD patients with severe...

  • Demenz und Depression determinieren Pflegebedürftigkeit bei M. Parkinson. Riedel, O.; Dodel, R.; Deuschl, G.; Förstl, H.; Henn, F.; Heuser, I.; Oertel, W.; Reichmann, H.; Riederer, P.; Trenkwalder, C.; Wittchen, H.U. // Der Nervenarzt;Aug2011, Vol. 82 Issue 8, p1012 

    Background: Parkinson's disease (PD) is frequently accompanied by dementia or depression which can aggravate the clinical picture of the disease and increase the risk of care dependency (CD). Little is known about the associations between PD, these neuropsychiatric comorbidities and CD in...

  • Teaching people with Parkinson's disease about their medication. O'Maley, Karen; O'Sullivan, John; Wollin, Judy; Barras, Michael; Brammer, Jillian // Nursing Older People;Mar2005, Vol. 17 Issue 1, p14 

    This article presents information on educating people with Parkinson's disease to manage their medication. Educating the person with PD about the use and side-effect profile of medications is one strategy that can be used to assist in maintaining quality of life. The specialist nurse has the...

  • Kinetic tremor in Parkinson’s disease – an underrated symptom. Kraus, P. H.; Lemke, M. R.; Reichmann, H. // Journal of Neural Transmission;Jul2006, Vol. 113 Issue 7, p845 

    Since the first description of the disorder which we now call “Parkinson’s Disease” (PD) much has changed not only because of new therapeutic possibilities. Initially only the rest tremor was described. Today it is generally accepted that PD can be accompanied by different...

  • Absence of cognitive deficits following deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease. Fraraccio, Maria; Ptito, Alain; Sadikot, Abbas; Panisset, Michel; Dagher, Alain // Archives of Clinical Neuropsychology;Jul2008, Vol. 23 Issue 4, p399 

    Abstract: Electrical stimulation of the subthalamic nucleus is an effective treatment for the motor symptoms of Parkinson''s disease. While most patients who undergo this procedure do not appear to suffer behavioral side effects, a minority experience cognitive or emotional deficits, and...

  • α-Synuclein pathology affecting Bergmann glia of the cerebellum in patients with α-synucleinopathies. Piao, Yue-Shan; Mori, Fumiaki; Hayashi, Shintaro; Tanji, Kunikazu; Yoshimoto, Makoto; Kakita, Akiyoshi; Wakabayashi, Koichi; Takahashi, Hitoshi // Acta Neuropathologica;Apr2003, Vol. 105 Issue 4, p403 

    We carried out immunohistochemical examinations of the brains (cerebella) of patients who had suffered from Parkinson's disease (PD), diffuse Lewy body disease (DLBD) or multiple system atrophy (MSA), using antibodies specific for α-synuclein. α-Synuclein-positive doughnut-shaped...


Read the Article


Sign out of this library

Other Topics