帕金森氏症患者的疼痛与运动并发症、焦虑和睡眠障碍有关

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2024-12-29 DOI:10.1002/ejp.4765

Katarina Rukavina, Juliet Staunton, Pavlos Zinzalias, Magdalena Krbot Skoric, Karolina Poplawska-Domaszewicz, Antonio Pisani, Kirsty Bannister, K Ray Chaudhuri

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引用次数: 0

摘要

帕金森病（PD）是第二常见的神经退行性疾病。超过三分之二的帕金森患者（PwP）患有慢性pd相关疼痛，但其成功管理仍然是一个未满足的需求。疼痛与PD的其他运动和非运动症状（NMS）之间尚未揭示的联系可能会加速PwP急需的精确疼痛药物方法的交付。方法对前瞻性、观察性、多中心、国际研究“PD - NILS的非运动国际纵向、现实研究”进行探索性、横断面分析。结果109例PwP患者（41.3%为女性，年龄64.29±9.80岁，病程5.50（2.44-10.89）年，H&；Y期2期（1-4），左旋多巴当量日剂量575.00 (315.00-1004.00)mg）， pd相关疼痛总负担和NMS总负担（rs = 0.641）与中度伴睡眠/疲劳障碍（rs = 0.483）、认知问题（rs = 0.445）、运动并发症（rs = 0.421）、睡眠/疲劳障碍（rs = 0.483）和NMS总负担（rs = 0.441）有很强的相关性。焦虑（rs = 0.441）和抑郁（rs = 0.451）。在多元线性回归分析中，运动并发症（B = 2.063, 95% CI为1.152-2.974,p < 0.001）、睡眠障碍/疲劳（B = 0.392, 95% CI为0.064-0.720,p = 0.020）和焦虑（B = 0.912, 95% CI为0.165-1.659,p = 0.017）显著影响了总体疼痛负担。结论在PwP中，pd相关疼痛明显受到运动并发症、焦虑和睡眠障碍的影响。一种个性化的、量身定制的方法来管理PwP中的疼痛需要准确地识别和处理其所有相关症状。运动并发症、焦虑和睡眠障碍的成功管理是否有助于缓解特定人群的PwP疼痛，需要成为未来随机对照临床试验的重点。这项探索性分析确定了帕金森病中慢性疼痛、运动并发症、睡眠障碍和焦虑的频繁重叠，有助于推进针对帕金森病患者需求的精确有效的疼痛管理策略的发展。

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Pain in Parkinson's disease is impacted by motor complications, anxiety and sleep disturbances

Background

Parkinson's disease (PD) is the second most common neurodegenerative disease. Over two thirds of People with Parkinson's (PwP) live with chronic PD-related pain, but its successful management remains an unmet need. Unrevealing links between pain and other motor and non-motor symptoms (NMS) of PD may accelerate delivery of much needed precision pain medicine approaches for PwP.

Methods

An exploratory, cross-sectional analysis of the prospective, observational, multicentre, international study ‘The Non-motor International Longitudinal, Real-Life Study in PD - NILS’.

Results

In 109 PwP (41.3% women, age 64.29 ± 9.80 years, disease duration 5.50 (2.44–10.89) years, H&Y stage 2 (1–4), levodopa equivalent daily dose 575.00 (315.00–1004.00) mg), strong correlations were noted between the total burden of PD-related pain and the total NMS burden (r_s = 0.641) and moderate with disturbances of sleep/fatigue (r_s = 0.483), cognitive issues (r_s = 0.445), motor complications (r_s = 0.421), anxiety (r_s = 0.441) and depression (r_s = 0.451). In a multivariate linear regression analysis, motor complications (B = 2.063, 95% CI for B 1.152–2.974, p < 0.001), sleep disturbances/fatigue (B = 0.392, 95% CI for B 0.064–0.720, p = 0.020) and anxiety (B = 0.912, 95% CI for B 0.165–1.659, p = 0.017) significantly impacted the overall burden of pain.

Conclusions

In PwP, PD-related pain is significantly impacted by motor complications, anxiety and sleep disturbances. A personalized, tailored approach to management of pain in PwP need to accurately identify and tackle all its interrelated symptoms. Whether successful management of motor complications, anxiety and sleep disturbances may contribute to pain relief in PwP for specified cohorts needs to be a focus of future randomized controlled clinical trials.

Significance statement

This explorative analysis identifies the frequent overlap of chronic pain, motor complications, sleep disturbances and anxiety in Parkinson's disease and could help advance the development of precise and effective pain management strategies tailored to the needs of People with Parkinson's.

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.