Objective: This study investigates the association between pain and motor symptom severity (MSS) in PD patients.

Background: Parkinson’s Disease (PD) is the second most common neurodegenerative disorder characterized by motor symptoms like bradykinesia, tremor, rigidity, and postural instability. These symptoms of PD severely impact physical abilities and functional independence. Pain, which also affects 67.6% of PD patients, varies in form and presentation and is often invisible and underdiagnosed.

Method: This analysis used data from a cross-sectional study on 52 Parkinson’s Disease (PD) patients conducted at Jena University Hospital, Germany. The dataset, available on Dryad, included demographics, clinical reports, assessments of coping strategies, quality of life, and pain. Descriptive statistics, a bivariate analysis, and an ordinal logistic regression model were executed to explore the association between pain and MSS. A causal inference analysis identified potential confounders and a sensitivity analysis assessed the impact of using pain intensity as an outcome [Figure 1]. The E-value was calculated to evaluate the strength of the association an unmeasured confounder needs to nullify the observed association [Figure 2].

Results:

50 Parkinson’s Disease (PD) patients were included, with 64% of these patients being male, with an average age of 76.1 years. The sample included 20 patients without pain and 30 with pain. The bivariate analysis did not identify significant differences between the pain and no-pain groups in disease duration, cognitive function, and non-motor symptoms. However, significant differences between groups emerged in motor symptom severity, coping strategies, and several SF-36 domains (Physical and Social Functioning, Role Functioning, Energy/Fatigue, Pain, General Health, and Health Change). In the multivariate analysis [table2], the estimate of Pain presence for low to medium motor symptom severity was OR 3.52 (95% CI:0.38 –  6.67) and the estimate for medium to severe was OR 5.44 (95% CI:2.03 – 8.86). In addition, being a male was associated with increased motor symptom severity OR 4.63 (95% CI:1.15-18.58).

Conclusion: Pain and MSS are associated, showing a stronger association in patients progressing from medium to severe MSS, following a dose-response relation. Prospective studies are needed  to verify these findings.

Figure 2

Figure 1

Table 1

Table 2

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-of-pain-with-motor-symptom-severity-in-parkinsons-disease-a-secondary-data-analysis/