Objective: To test the hypothesis that chronic pain may be associated with higher levodopa equivalent daily dosage (LEDD), and that patients who develop artistic creativity may experience lower exposure to pain,
Background: Pain is a very frequent symptom in Parkinson’s Disease (PD) and may sometimes be more disabling than motor symptoms. In many cases its origin cannot be clearly identified and it may be refractory to conventional treatments. Interestingly, pain may fluctuate during the same day, often paralleling motor ON–OFF fluctuations, suggesting a possible involvement of dopaminergic circuits. Conversely, the development of artistic creativity during PD has also been described in the literature.
Method: To test the hypothesis that chronic pain may be associated with higher levodopa equivalent daily dosage (LEDD), and that patients who develop artistic creativity may experience lower exposure to pain, we conducted a pilot retrospective observational case–control study on 200 PD patients, comparing groups with and without chronic pain.
Results: PD patients with chronic pain, assessed using the King’s Parkinson’s Disease Pain Scale, showed significantly higher LEDD (p < 0.01). They also exhibited a significantly higher prevalence of positive screening for Dopaminergic Dysregulation Syndrome (DDS) on both the DDS-related items of the UPDRS and the QUIP-RS. In addition, these patients had higher scores for depression and insomnia on the Non-Motor Symptoms Scale (NMSS).
In contrast, among PD patients without chronic pain we observed a prevalence of 20% of individuals reporting creative activities such as painting, music, crafts, or sculpture. This subgroup was also characterized by lower caregiver burden scores and lower levels of sedentary behavior.
Conclusion: Beyond disease-related, personality, and social factors, PD patients treated with L-DOPA may follow different behavioral trajectories. Some develop pharmacological dependence associated with chronic pain and dopaminergic dysregulation, others show a predominantly motor response to treatment, while a third group may channel dopaminergic stimulation not only into motor function but also into positive emotional expression and artistic creativity.
To cite this abstract in AMA style:
G. Albani, GP. Mingolla, M. Giardini, S. Corna. Three Different Behavioral Trajectories in L-DOPA–Treated Parkinson’s Disease Patients [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/three-different-behavioral-trajectories-in-l-dopa-treated-parkinsons-disease-patients/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/three-different-behavioral-trajectories-in-l-dopa-treated-parkinsons-disease-patients/