Objective: Investigate the relationship between the dose of dopamine replacement therapy (DRT) and pain severity as measured by the King’s Parkinson’s Disease Pain Scale (KPPS) in Mexican PD population.

Background: Parkinson’s disease (PD) is a chronic and progressive neurological disorder that affects more than 10 million people worldwide. One of the most common symptoms of PD is pain, which can significantly impact the quality of life of patients and is often underdiagnosed and undertreated. While DRT is effective in reducing motor symptoms of PD, its impact on pain relief is less clear. Some studies have suggested that DRT may alleviate pain in patients with PD, while others have found no significant effect or even worsening of pain with increasing DRT doses.

Method: 200 Mexican with PD (59% males, 41% females; 63.81 ± 11.78 years old; age at diagnosis 56.80 ± 12.47) were included in this cross-sectional and retrospective study was conducted using information from the ReMePARK registry between 2012 and 2023. Variables of interest included gender, age, PD evolution in years, age at onset of pain, among others. Patients were categorized based on the antiparkinsonian treatment they received in addition to levodopa (LD) (90.4% patients with LD, 14.9% monoamine oxidase inhibitors (MAOIs), 51.9% with dopamine agonists (DA)). The variables of greatest interest were the daily doses of the different antiparkinsonian drugs used and the total score on the King’s Parkinson’s Disease Pain Scale (KPPS) (mean score 6.74 ± 11.375). A bivariate correlation analysis was conducted using Spearman’s coefficient.

Results: A negative mild correlation was found between the dose of DA and the KPPS score (r=-0.141, p<0.001). However, the correlation coefficient was stronger for MAOIs (r=-0.272, p<0.001) showing that higher doses of MAOIs correlate with lower pain severity.

Conclusion: Our study provides evidence for a significant relationship between the dose of DRT and pain severity in patients with PD. Further research is needed to explore the underlying mechanisms of this relationship and to determine the optimal dose of DRT for pain relief in patients with PD. To comprehensively assess the treatment of the participants, it is necessary to establish dose equivalence with levodopa in our population.

References: 1. Marques A, Brefel-Courbon C. Chronic pain in Parkinson’s disease: Clinical and pathophysiological aspects. Rev Neurol (Paris) [Internet]. 2021;177(4):394–9. https://pubmed.ncbi.nlm.nih.gov/33019996/

2. Rukavina K, Leta V, Sportelli C, Buhidma Y, Duty S, Malcangio M, et al. Pain in Parkinson’s disease: new concepts in pathogenesis and treatment. Curr Opin Neurol [Internet]. 2019;32(4):579–88. https://pubmed.ncbi.nlm.nih.gov/31260418/

3. Ghosh P, Imbriani P, Caputi N, Natoli S, Schirinzi T, Di Lazzaro G, et al. A dual centre study of pain in Parkinson’s disease and its relationship with other non-motor symptoms. J Parkinsons Dis [Internet]. 2020;10(4):1817–25. https://pubmed.ncbi.nlm.nih.gov/33016892/

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-dose-of-dopamine-replacement-therapy-and-kings-parkinsons-disease-pain-scale-in-mexican-patients-with-parkinsons-disease/