Objective: To evaluate and compare the applicability of KPPS and the PD-PCS in patients with Parkinson’s disease

Background: Pain assessment in PD remains a relevant clinical challenge due to its numerous etiologies in PD population and to the lack of a routine systematic approach to this matter. Comparative data comparing instruments designed to facilitate this approach remains limited

Method: This prospective observational cohort study included 45 patients with idiopathic PD followed at a tertiary Movement Disorders outpatient clinic. Both instruments were administered at baseline and after approximately eight weeks, with one assessment performed in person and the other through telemedicine. Patients were evaluated in the same day, by two different raters, before and after a routine follow up clinical evaluation. Follow-up assessment was performed by a different single rater. Time to apply each scale, pain type classification, changes in pain intensity, and associations with clinical, cognitive, emotional, and functional variables were analyzed.

Results: Pain was present in 91% of the sample, with predominance of nociceptive pain (approximately 71%). Both instruments demonstrated good clinical feasibility. PD-PCS showed greater sensitivity for mechanistic pain characterization and for detecting clinically meaningful changes during follow-up, with a significant reduction in pain intensity (63.4 ± 55.1 [0–192] vs. 57.8 ± 54.4 [0–210]; p = 0.024). KPPS demonstrated a significant reduction in administration time during reassessment through telemedicine (4.4 ± 1.4 vs. 2.7 ± 1.2; p < 0.001) but was unable to detect differences in pain intensity. Anxiety emerged as an independent predictor of higher pain intensity in both instruments (PD-PCS: p = 0.0117; KPPS: p = 0.0095). Female patients exhibited greater pain intensity (78.5 ± 48.7 vs. 53.3 ± 58.0; p = 0.024), but a lower LEED dosage when compared to males (737,5 ± 237 vs. 1.090 ± 195mg; p < 0,001)

Conclusion: These findings indicate that both tools were able to detect pain in a high frequency. PD-PCS had a higher discriminatory power to distinguish pain related to PD subtypes and had a higher sensibility to detect pain variations on follow up assessment, suggesting that is a better method for PD’s pain diagnosis and to be used in follow up assessments.

References: CIAMPI DE ANDRADE, D.; MYLIUS, V.; PEREZ-LLORET, S.; CURY, R. G.; BANNISTER, K.; MOISSET, X.; TARICANI KUBOTA, G.; FINNERUP, N. B.; BOUHASSIRA, D.; CHAUDHURI, K. R.; GRAVEN-NIELSEN, T.; TREEDE, R.-D. Narrative Review Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them. 2023b. Disponível em: .

MYLIUS, V.; PEREZ LLORET, S.; CURY, R. G.; TEIXEIRA, M. J.; BARBOSA, V. R.; BARBOSA, E. R.; MOREIRA, L. I.; LISTIK, C.; FERNANDES, A. M.; DE LACERDA VEIGA, D.; BARBOUR, J.; HOLLENSTEIN, N.; OECHSNER, M.; WALCH, J.; BRUGGER, F.; HÄGELE-LINK, S.; BEER, S.; RIZOS, A.; CHAUDHURI, K. R.; BOUHASSIRA, D.; LEFAUCHEUR, J. P.; TIMMERMANN, L.; GONZENBACH, R.; KÄGI, G.; MÖLLER, J. C.; CIAMPI DE ANDRADE, D. The Parkinson disease pain classification system: Results from an international mechanism-based classification approach. Pain, v. 162, n. 4, p. 1201–1210, 1 abr. 2021

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pain-assessment-using-parkinsons-disease-pain-classification-system-pd-pcs-and-kings-parkinson-disease-pain-scale-kpps-a-comparative-study/