Among the different types of pain observed in Parkinson's disease, parkinsonian central pain (PCP) has the highest severity, and is poorly characterized and difficult to describe not only by patients but also by neurologists. Thus PCP remains not strictly defined and is difficult to distinguish from other types of pain on the basis of clinical description. Yet, standardizing PCP diagnosis is critical to improve the treatment of this debilitating pain subtype, but also to homogenize further studies investigating the pathophysiological mechanisms underlying this condition. Accounting for the lack of reliable validated positive clinical criteria for PCP, and as the clinical features of PCP are difficult to specify, we suggest to consider so far the gold standard diagnosis of PCP mainly based on exclusion criteria. We propose a new algorithm aiming to disentangle PCP from other chronic pain subtypes in Parkinson's disease, by sequentially ruling out what PCP is not.
Keywords: Central pain; Classification; Criteria; Diagnosis; Parkinson.
Copyright © 2019 Elsevier Ltd. All rights reserved.
Sleep disturbances in Parkinson's disease are associated with central parkinsonian pain.J Pain Res. 2019 Jul 12;12:2137-2144. doi: 10.2147/JPR.S206182. eCollection 2019. J Pain Res. 2019. PMID: 31372031 Free PMC article.
Chronic pain in Parkinson's disease: Frequency, characteristics, independent factors, and relationship with health-related quality of life.J Back Musculoskelet Rehabil. 2016 Jun 3. doi: 10.3233/BMR-160720. Online ahead of print. J Back Musculoskelet Rehabil. 2016. PMID: 27284853
Quantitative PCR to diagnose Pneumocystis pneumonia in immunocompromised non-HIV patients.Eur Respir J. 2012 Apr;39(4):971-8. doi: 10.1183/09031936.00095811. Epub 2011 Sep 15. Eur Respir J. 2012. PMID: 21920890
Clinical diagnosis of Parkinson's disease. Proposal of diagnostic subgroups classified at different levels of confidence.Acta Neurol Scand. 1994 Apr;89(4):242-51. doi: 10.1111/j.1600-0404.1994.tb01674.x. Acta Neurol Scand. 1994. PMID: 8042440 Review.
The "Parkinsonian heart": from novel vistas to advanced therapeutic approaches in Parkinson's disease.Curr Med Chem. 2007;14(23):2421-8. doi: 10.2174/092986707782023631. Curr Med Chem. 2007. PMID: 17979697 Review.