Objective: To compare the performance of several pain measures, self- and rater-based, in PD patients.

Background: Pain is a prevalent and complex symptom in Parkinson’s disease (PD). Several scales are available to assess pain in PD, including patient-reported outcomes and rater-based scales, such as the King’s Parkinson’s Disease Pain Scale (KPPS). 

Methods: Data were extracted from the KPPS validation study (Chaudhuri et al, 2015). Pain assessment was made by self-administered (visual analogue scale –VAS- for pain, and EQ-5D and PDQ-8 items for pain), and rater-based measures (KPPS and NMSS item for pain). Other validated rating scales for PD symptoms assessment were also applied. Data analysis included correlation coefficients, comparison of pain scores between groups according to variables of interest and multivariate linear regression models with KPPS and VAS-pain as dependent variables.

Results: The sample was composed by 178 PD patients with non-explained pain. Mean age was 64.38 years (SD: 11.38) and disease duration, 5.4 (SD: 4.93). Patients were mainly in HY stage 2 (47.7%). Correlation coefficients between pain scales were low to moderate: from 0.21 (NMSS item 27 with KPPS) to 0.54 (KPPS with VAS-pain). KPPS obtained the highest correlation coefficients with the rest of measures: 0.64 with PDSS and 0.59 with NMSS. VAS-pain correlated 0.51 with global severity of PD (CISI-PD). All measures of pain showed the highest scores in patients with longest disease duration. Only KPPS and VAS-pain showed significant differences according to disease severity (HY). No significant differences in pain scores were found in relation to sex, age and age at onset. In the regression models, KPPS and VAS-pain showed associations with sleep disorders and motor symptoms, controlling for other variables.

Conclusions: Pain measures KPPS and VAS-pain showed the strongest associations with other clinical variables in PD. Our results suggest that pain assessment in PD should be done with a combination of rater- and patient-based measures.

References: Chaudhuri KR, Rizos A, Trenkwalder C, Rascol O, Pal S, Martino D, Carroll C, Paviour D, Falup-Pecurariu C, Kessel B, Silverdale M, Todorova A, Sauerbier A, Odin P, Antonini A, Martinez-Martin P; EUROPAR and the IPMDS Non Motor PD Study Group.. King’s Parkinson’s disease pain scale, the first scale for pain in PD: An international validation. Mov Disord. 2015 Oct;30(12):1623-31. doi: 10.1002/mds.26270.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-pain-in-parkinsons-disease-comparison-between-clinical-and-self-reported-measures/