Objective: To describe clinical characteristics and short-term pain outcomes after functional intramuscular stimulation (FIMS) in patients with Parkinson’s disease or sporadic amyotrophic lateral sclerosis.

Background: Pain is a prevalent, multifactorial non-motor symptom in Parkinson’s disease; recent reviews report average prevalence around 67%, with musculoskeletal pain commonly involving the lower limbs, lumbar spine, and other joints [1][2]. Pain is also common in amyotrophic lateral sclerosis, with pooled prevalence around 60%, frequent shoulder/extremity or cramp/spasm pain, and substantial quality-of-life burden [3][4]. Dry needling/intramuscular stimulation has shown analgesic benefit in myofascial pain populations, but disease-specific evidence in neurodegenerative disorders is sparse [5][6].

Method: We performed a retrospective single-center review of one-year diagnosis and procedure data. Patients with Parkinson’s disease (G20) or sporadic amyotrophic lateral sclerosis (G12.21) who underwent FIMS were identified by cross-referencing diagnosis and procedure codes. Demographics, treated body regions, number of sessions, and pre/post visual analog scale (VAS) scores were extracted. Paired VAS data were summarized using patient-level averages.

Results: Among 74 patients with Parkinson’s disease or amyotrophic lateral sclerosis identified during the study period, 13 underwent FIMS: 12 with Parkinson’s disease and 1 with sporadic amyotrophic lateral sclerosis. Mean age was 72.8 ± 9.3 years, and 23.1% were male. Patients underwent 22 sessions and 38 procedures (mean 1.7 ± 0.9 sessions/patient) over a mean treatment duration of 43.9 ± 62.5 days [table1]. Lumbar spine and hip were the most commonly treated sites. Paired VAS data were available for 12 patients across 19 sessions and 37 treated regions. Mean patient-level VAS improved from 7.8 ± 1.2 before FIMS to 1.3 ± 0.6 after FIMS, a mean reduction of 6.5 ± 1.4 points (83.0% improvement; p<0.001).

Conclusion: In this small retrospective series, FIMS was associated with marked short-term pain reduction in Parkinson’s disease and sporadic amyotrophic lateral sclerosis, particularly for lumbar spine and hip pain. Prospective controlled studies with standardized functional and longitudinal outcomes are needed.

Table 1

References: [1] Nogueira ACR, Pereira KC, Rodrigues VF, Alves DDPA, Marques JB, Monteiro ER, et al. Pain characterization in patients with Parkinson’s disease. Pain Pract. 2024;24(5):786-797. doi:10.1111/papr.13352.
[2] Li J, Zhu BF, Gu ZQ, Zhang H, Mei SS, Ji SZ, et al. Musculoskeletal Pain in Parkinson’s Disease. Front Neurol. 2022;12:756538. doi:10.3389/fneur.2021.756538.
[3] Hurwitz N, Radakovic R, Boyce E, Peryer G. Prevalence of pain in amyotrophic lateral sclerosis: a systematic review and meta-analysis. Amyotroph Lateral Scler Frontotemporal Degener. 2021;22(7-8):449-458. doi:10.1080/21678421.2021.1892765.
[4] Ishida N, Hongo S, Kumano A, Hatta H, Zakoji N, Hirutani M, et al. Relationship between Pain and Functional Status in Patients with Amyotrophic Lateral Sclerosis: A Multicenter Cross-Sectional Study. J Palliat Med. 2018;21(5):588-591. doi:10.1089/jpm.2017.0503.
[5] Guzmán-Pavón MJ, Torres-Costoso AI, Cavero-Redondo I, Reina-Gutiérrez S, Lorenzo-García P, Álvarez-Bueno C. Effectiveness of deep dry needling combined with stretching for the treatment of pain in patients with myofascial trigger points: a systematic review and meta-analysis. J Bodyw Mov Ther. 2024;40:1086-1092. doi:10.1016/j.jbmt.2024.07.003.
[6] Brandín-de la Cruz N, Calvo S, Rodríguez-Blanco C, Herrero P, Bravo-Esteban E. Effects of dry needling on gait and muscle tone in Parkinson’s disease: a randomized clinical trial. Acupunct Med. 2022;40(1):3-12. doi:10.1177/09645284211039232.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-intramuscular-stimulation-for-pain-in-parkinsons-disease-and-sporadic-amyotrophic-lateral-sclerosis-a-retrospective-case-series/