Study on related risk factors of pain in de novo Parkinson's disease patients

Abstract

Objective To explore the risk factors of pain in de novo Parkinson's disease (PD) patients. Methods A total of 129 de novo PD patients collected from The Affiliated Brain Hospital of Nanjing Medical University from October 2018 to September 2021 were included. According to the Item ⁃17 of the Unified Parkinson's Disease Rating Scale Ⅱ (UPDRSⅡ⁃17th), patients were classified as PD patients without pain (UPDRSⅡ⁃17th was 0, n = 88) and PD patients with pain (UPDRSⅡ⁃17th ≥ 2, n = 41）. Mini⁃ Mental State Examination (MMSE) and corrected Montreal Cognitive Assessment (corrected MoCA) were used to assess cognitive function. Meanwhile, Hamilton Depression Rating Scale ⁃24 Items (HAMD ⁃24) was used to assess the depression status and the UPDRSⅢ was used to assess the motor function. The modified version of Hoehn ⁃Yahr staging was used to assess disease severity. The related risk factors of pain in PD patients were analyzed by univariate and multivariate forward Logistic regression. Results The incidenceof pain in PD patients was 31.78% (41/129). Compared with PD without pain group, PD with pain group had lower scores in MMSE (Z = ⁃ 2.389, P = 0.017) and corrected MoCA (Z = ⁃ 2.166, P = 0.030), but higher scores in HAMD ⁃24 (Z = ⁃ 4.024, P = 0.000), UPDRS Ⅲ (Z = ⁃ 3.639, P = 0.000） and Hoehn ⁃Yahr staging grading (Z = ⁃ 2.232, P = 0.026). Further analysis of the differences between 2 groups in 7 domains of HAMD⁃24 showed PD with pain group had higher scores of the anxiety/somatization (Z = ⁃ 3.707, P = 0.000), mental disorder (Z = ⁃ 2.519, P = 0.012), retardation symptom (Z = ⁃ 2.048, P = 0.041), sleep disturbances (Z = ⁃ 3.484, P = 0.000) and despair symptom (Z = ⁃ 3.069, P = 0.002) than PD without pain group. Logistic regression analysis showed long duration (OR = 1.354, 95%CI: 1.013-1.809; P = 0.041), high HAMD ⁃ 24 score (OR = 1.095, 95%CI: 1.033-1.162; P = 0.002) and high UPDRSⅢ score (OR = 1.040, 95%CI: 1.001- 1.082; P = 0.046) were risk factors of pain in PD patients. Conclusions Pain in PD has a high incidence in de novo PD patients. Long duration, a depressed state and severe motor symptoms are main risk factors for the development of pain in PD patients.

doi：10.3969/j.issn.1672⁃6731.2022.03.009