Objective: To study interrelation of chronic pain syndrome and cognitive and affective disorders in patients with PD

Background: Parkinson’s disease (PD) is characterized by well-known motor symptoms as well as by non-motor symptoms including pain syndrome which remains poorly understood and often ignored by physicians

Methods: 109 patients (ages 65,8±8,5) with PD were examined. Two groups:1st (75 pers.) – patients with chronic pain syndrome, 2nd (34 pers.) – patients without pain were formed. Patients with pain and without pain did not differ by age, disease severity (assessed on a scale Hyun-Yar) and duration.

Assessment of movement disorders (UPDRS), of pain (VAS, pressalgometry), of cognitive functions (MMSE), of attention (Wechsler Adult Intelligense Scale – WAIS), of visual-spatial functions («drawing hours» test (Manos, 1994)), of memory (visual memory test of SKT scale (H.Lehbeld, H.Erzigkeit, 1980)), of speech (test on the availability and directional association (AR Luria, 1969)), of affective disorders (Beck Depression Inventory, Scale obsessive-compulsive syndrome (Goodman et al, 1984)) were performed.

Results:

Assessment of the general state of patients’ cognitive functions on MMSE ranged from 27 to 30 points (averaged 28,8 points). The group of patients with pain had lower indicators of neuropsychological functions than patients without pain (p<0,05). Patients with pain had more pronounced disturbances than patients without pain at performance of clock drawing test (7,5±1,1 versus 9,2±0,7), «coding» test (26,8±11,5 versus 34,1±8,2), on speech activity test (10,9±6,7 versus 14,7±3,5), visual memory test (6,9±2,2 versus 9,6±2,5), (p<0,05). However, patients with pain did not differ from patients without pain on the overall level of cognitive function and abstract thinking.

Depressive symptoms were observed in 49 (69%) patients with pain syndrome (17,3±7,6 points) and in 11 (28%) patients without pain (12,6±6,8 points). Intensity of pain assessed by the VAS correlated with the severity of depressive symptoms (R=0,51; p<0,001). Intensity of pain in patients from 1st group was higher (53,8±23,2 points) than in patients without pain (43,6±19,1 points), (P=0,03).

Conclusions:

The development of chronic pain in patients with PD is associated with depressive, obsessive-compulsive symptoms and neurodynamic and regulatory cognitive impairment

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MDS Abstracts - https://www.mdsabstracts.org/abstract/interrelation-between-chronic-pain-syndrome-and-cognitive-and-affective-disturbances-in-patients-with-parkinsons-disease/