Towards optimising experimental quantification of persistent pain in Parkinson's disease using psychophysical testing.
Towards optimising experimental quantification of persistent pain in Parkinson's disease using psychophysical testing.
复制标题
DOI：
10.1038/s41531-021-00173-y
复制
发表时间：
2021-03-17
期刊：
影响因子：
--
通讯作者：
Cummins TM
中科院分区：
文献类型：
--
作者：
Bannister K;Smith RV;Wilkins P;Cummins TM
帕金森氏症(PD)患者在确诊后可能会活几十年。确保在所经历的各种症状中获得有效的医疗保健服务，对个人的福祉和生活质量至关重要。除了显著的运动症状外，帕金森病患者还可能出现包括持续性疼痛在内的非运动症状。这种类型的疼痛(持续3个月以上)的描述不一致，对其了解也很少，导致治疗选择有限。基于证据的止痛药正在涌现，但提供改善止痛药特征的治疗策略仍然是一个未得到满足的临床需求。由于能够在帕金森病背后的神经退行性变化和导致持续性疼痛的适应不良疼痛处理基础之间建立联系，可以阐明疾病启动、进展和维持的机制或风险因素，我们评估了最新的研究文献，试图通过实验量化来确定帕金森病持续性疼痛的原因。以前的大多数研究旨在确定神经生物学改变，这些改变可以为帕金森病队列中的疼痛/疼痛表型提供生物标记物。然而，人类心理物理学研究之间患者队列、结果结果和方法学的异质性压倒性地导致了不确定和模棱两可的证据。在这里，我们讨论Pain-PD范式的改进，以便未来的研究可以增强对所观察到的效应大小的有效性的信心，同时也通过标准化来帮助可比性。令人鼓舞的是，随着该领域走向数据的交叉研究比较，以便更可靠地揭示功能障碍疼痛处理的潜在机制，更有针对性的治疗和管理的潜力很高。
People with Parkinson’s disease (PD) may live for multiple decades after diagnosis. Ensuring that effective healthcare provision is received across the range of symptoms experienced is vital to the individual’s wellbeing and quality of life. As well as the hallmark motor symptoms, PD patients may also suffer from non-motor symptoms including persistent pain. This type of pain (lasting more than 3 months) is inconsistently described and poorly understood, resulting in limited treatment options. Evidence-based pain remedies are coming to the fore but therapeutic strategies that offer an improved analgesic profile remain an unmet clinical need. Since the ability to establish a link between the neurodegenerative changes that underlie PD and those that underlie maladaptive pain processing leading to persistent pain could illuminate mechanisms or risk factors of disease initiation, progression and maintenance, we evaluated the latest research literature seeking to identify causal factors underlying persistent pain in PD through experimental quantification. The majority of previous studies aimed to identify neurobiological alterations that could provide a biomarker for pain/pain phenotype, in PD cohorts. However heterogeneity of patient cohorts, result outcomes and methodology between human psychophysics studies overwhelmingly leads to inconclusive and equivocal evidence. Here we discuss refinement of pain-PD paradigms in order that future studies may enhance confidence in the validity of observed effect sizes while also aiding comparability through standardisation. Encouragingly, as the field moves towards cross-study comparison of data in order to more reliably reveal mechanisms underlying dysfunctional pain processing, the potential for better-targeted treatment and management is high.
登录
查看更多内容
影响因子：
3.6
作者：
Cummins, Tatum M.;Kucharczyk, Mateusz M.;Bannister, Kirsty
通讯作者：
Bannister, Kirsty
影响因子：
8.6
作者：
Brefel-Courbon, C;Payoux, P;Rascol, O
通讯作者：
Rascol, O
影响因子：
56.9
作者：
Bonifati, V;Rizzu, P;Heutink, P
通讯作者：
Heutink, P
影响因子：
8.6
作者：
Chaudhuri, Kallol Ray;Martinez-Martin, Pablo;Schapira, Anthony H. V.
通讯作者：
Schapira, Anthony H. V.
影响因子：
6
作者：
Buhmann, Carsten;Wrobel, Nathalie;Bingel, Ulrike
通讯作者：
Bingel, Ulrike