Objective: We investigated the frequency and clinical characteristics of superior cluneal neuralgia (SCN) in patients with Parkinson’s disease (PD).
Background: The superior cluneal nerve is a cutaneous branch of the posterior root of the spinal nerve Th11-L4, and in recent years it has attracted attention as a cause of unexplained unilateral low back pain, with a reported frequency of 1.3-15% of low back pain cases. However, there are insufficient data on its incidence and clinical characteristics in PD.
Method: We evaluated the presence or absence of back pain and the presence or absence of symptoms characteristic of SCN damage in 92 consecutive PD patients who were outpatients at our hospital, in addition to evaluating their clinical symptoms. We also re-evaluated 61 patients after 1 year. At 1 year follow-up, patients with SCN still had higher UPDRS part 1 scores and there was a trend towards greater reduction in motor symptoms.
Results: The mean age of the patients was 70.2±11.3 years, the mean disease duration was 7.4±6.5 years, and the mean MDS-UPDRS part 3 score was 32.2±13.6. Fifty-two patients (56%) had back pain, and there were no differences in clinical symptoms, disease duration, etc. between patients with and without back pain.
Of the 52 patients with back pain, 12 (23%) had SCN and their symptoms improved with nerve block. When comparing patients with and without SCN, patients with SCN had more severe pain (VAS 65.8±22.1 vs 37.5±21.7) and higher UPDRS part 1 scores (14.8±5.2 vs 10.5±5.0).
At 1 year follow-up, patients with SCN still had higher UPDRS part 1 scores and there was a trend towards a greater decrease in motor symptoms.
Conclusion: SCN accounts for 25% of PD-related back pain and SCN may be associated with poorer quality of life due to more severe back pain and faster motor symptom decline. SCN is highly responsive to treatment and is an important consideration in clinical practice.
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To cite this abstract in AMA style:
M. Mihara, Y. Kajiyama, A. Saito, R. Satake, Y. Kutoku. Superior cluneal neuralgia in Parkinson’s disease: frequency and clinical features. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/superior-cluneal-neuralgia-in-parkinsons-disease-frequency-and-clinical-features/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/superior-cluneal-neuralgia-in-parkinsons-disease-frequency-and-clinical-features/