Objective: The aim of this study was whether the pain is a unique feature of Parkinson’s disease, which precedes motor symptoms, and its characteristics would be different from the pain of other parkinsonism including atypical parkinsonism and vascular parkinsonism

Background: Pain is common in Parkinson’s disease (PD) and is considered a pre-motor symptom suggesting sensory involvement in the pre-motor stage. Pain in other parkinsonian disorders such as atypical parkinsonism and vascular parkinsonism (VP) has been investigated in only a few studies.

Method: 236 PD, 42 multiple system atrophy (MSA), 31 progressive supranuclear palsy (PSP), and 38 VP patients were screened for pain. After excluding patients with dementia and pain not related to PD, presence of pain, severity, onset, type, and location of pain were compared among the four patient groups.

Results: Difference was not observed in pain presence (X2 = 3, p = 0.186), severity (F = 1.534, p= 0.207), or type (X2 = 6, p = 0.400) among the four groups. However, the temporal relationship between pain and motor symptoms differed (H(3) = 8.764, p = 0.033). Pain predated motor symptoms in PD, MSA, VP but followed motor symptoms in PSP. The pain location in the body was different among the four patient groups (X2 = 21, p = 0.018), and leg involvement was more common in PSP

Conclusion: This study was conducted with undemented patients, and most were in the early stage before starting medication. Pain was shown to be a pre-motor symptom in PD, MSA, and VP patients but not in PSP patients, implying different pain pathogeneses in these disorders Furthermore, pain locations were different for each group, which requires additional studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsonian-disorders-may-have-different-pain-features/