Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them

• Autores: Ciampi de Andrade, Daniel; Mylius, Veit; Pérez Lloret, Santiago; Cury, Rubens G.; Bannister, Kirsty; Moisset, Xavier; Taricani Kubota, Gabriel; Finnerup, Nanna B.; Bouhassira, Didier; Chaudhuri, Kallol Ray; Graven Nielsen, Thomas; Treede, Rolf Detlef
• Año de publicación: 2023
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: PAIN. 2023, 164 (11).
• Materia: ENFERMEDAD DE PARKINSON; RIGIDEZ; DOLOR CRONICO; DOLOR NEUROPATICO; DOLOR MUSCULOESQUELETICO; DOLOR SECUNDARIO; DOPAMINA; ESTIMULACION CEREBRAL
• Institución: Pontificia Universidad Católica Argentina

Fil: Ciampi de Andrade, Daniel. Aalborg University. Faculty of Medicine. Department of Health Science and Technology. Center for Neuroplasticity and Pain. Dinamarca
Fil: Mylius, Veit. Centre for Neurorehabilitation. Department of Neurology; Suiza
Fil: Mylius, Veit. Philipps University, Marburg. Department of Neurology; Alemania
Fil: Mylius, Veit. Kantonsspital. Department of Neurology; Suiza
Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Consejo de Investigaciones Científicas y Técnicas. Observatorio de Salud Publica; Argentina
Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Facultad de Medicina; Argentina
Fil: Pérez Lloret, Santiago. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Fisiología; Argentina
Fil: Cury, Rubens G. University of Sao Paulo. Department of Neurology. Movement Disorders Center; Brasil
Fil: Bannister, Kirsty. Institute of Psychiatry, Psychology and Neuroscience. King’s College London; Reino Unido
Fil: Moisset, Xavier. Universite´ Clermont Auvergne, Centre hospitalier universitaire de Clermont-Ferrand. Inserm, Neuro- Dol, Clermont-Ferrand; Francia
Fil: Taricani Kubota, Gabriel. Centre for Neurorehabilitation. Department of Neurology; Suiza
Fil: Taricani Kubota, Gabriel. University of Sao Paulo Clinics Hospital. Pain Center; Brasil
Fil: Taricani Kubota, Gabriel. University of Sao Paulo Clinics Hospital. Pain Treatment, Institute of Cancer of the State of Sao Paulo; Brasil
Fil: Finnerup, Nanna B. Aarhus University. Department of Clinical Medicine. Danish Pain Research Center; Dinamarca
Fil: Finnerup, Nanna B. Aarhus University Hospital. Department of Neurology; Dinamarca
Fil: Bouhassira, Didier. Paris-Saclay University, Ambroise Pare Hospital. Université de Versailles Saint-Quentin. Assistance publique hôpitaux de Paris; Francia
Fil: Chaudhuri, Kallol Ray. Institute of Psychiatry, Psychology and Neuroscience. King’s College London. Division of Neuroscience. Department of Basic and Clinical Neuroscience; Reino Unido
Fil: Chaudhuri, Kallol Ray. King’s College Hospital National Health Service Foundation Trust. Parkinson Foundation Centre of Excellence in Care and Research: Reino Unido
Fil: Graven Nielsen, Thomas. Aalborg University. Faculty of Medicine. Department of Health Science and Technology. Center for Neuroplasticity and Pain. Dinamarca
Fil: Treede, Rolf Detlef. Heidelberg University. Department of Neurophysiology. Mannheim Center for Translational Neurosciences; Alemania
Abstract: Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause of functional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD both in prodromal phases and during the subsequent stages of the disease, negatively affecting patient’s quality of life and function. Pain in PwPD is rather heterogeneous and may occur because of different mechanisms. Targeting motor symptoms by dopamine replacement or with neuromodulatory approaches may only partially control PD-related pain. Pain in general has been classified in PwPD according to the motor signs, pain dimensions, or pain subtypes. Recently, a new classification framework focusing on chronic pain was introduced to group different types of PD pains according to mechanistic descriptors: nociceptive, neuropathic, or neither nociceptive nor neuropathic. This is also in line with the International Classification of Disease-11, which acknowledges the possibility of chronic secondary musculoskeletal or nociceptive pain due to disease of the CNS. In this narrative review and opinion article, a group of basic and clinical scientists revise the mechanism of pain in PD and the challenges faced when classifying it as a stepping stone to discuss an integrative view of the current classification approaches and how clinical practice can be influenced by them. Knowledge gaps to be tackled by coming classification and therapeutic efforts are presented, as well as a potential framework to address them in a patient oriented manner.