Objective: To identify clinical characteristics, predictors and biomarkers of pain at baseline and after a two-year follow-up period in newly diagnosed drug-naïve Parkinson’s Disease (PD) patients enrolled in the Parkinson’s Progression Markers Initiative (PPMI) database.

Background: Pain is a frequent and sometimes disabling non-motor symptom of PD.

Methods: The PPMI is a cohort study aimed at identifying clinical, imaging and biologic markers of PD progression. For this sub-study, 422 newly diagnosed drug-naïve PD patients and 195 healthy controls were included. Patients were assessed by means of the MDS-UPDRS, MoCA, SCOPA, ESS, RBD Screening Questionnaire, GDS-15, STAI, and UPSIT. DAT imaging was used to assess dopaminergic loss. Levels of β-amyloid fragment 1-42, α-synuclein and total or phosphorylated tau proteins were measured in cerebrospinal fluid (CSF). The main outcome was pain, defined as MDS-UPDRS item 1.9 (pain and other sensations) ≥ 1.

Results: Pain prevalence at baseline was higher in PD (n=221/422, 52%) compared to healthy controls (n=65/195, 33%, p<0.01), even after adjusting for gender, age, education, depression scores, cognitive state and presence of painful comorbidities (i.e. lower back, neuropathic and muscular pain, spinal cord injuries, headache, fractures, fibromyalgia, cancer). A multivariate logistic regression revealed that only gender, anxiety and MDS-UPDRS II+III scores were independently and significantly associated with the presence of pain at baseline in PD. Pain was significantly more frequent at Year 2 (n=225/364, 62%) as compared to baseline (p<0.01). A logistic regression analysis disclosed that the only independent and significant predictors of pain at Year 2 were the presence of pain at baseline, female gender, PD duration and severity, and reduced CSF levels of total tau protein.

Conclusions: Pain was more frequent in PD compared to controls and correlated with disease progression and gender. It was also observed, for the first time, that reduced total tau protein is likely to be a significant biomarker for pain at Year 2 in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-and-biomarkers-of-pain-in-newly-diagnosed-parkinsons-disease-patients-during-a-two-year-follow-up/