scholarly journals Current Status of Pain Management in Parkinson’s Disease

2020 ◽  
Vol 47 (3) ◽  
pp. 336-343
Author(s):  
Vikram Karnik ◽  
Nicole Farcy ◽  
Carolina Zamorano ◽  
Veronica Bruno
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pain Management ◽  
Statistical Significance ◽  
Current Status ◽  
Open Label ◽  
Adequate Treatment ◽  
Pain Thresholds ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

ABSTRACT:Background:Pain is a non-motor symptom in Parkinson’s disease (PD) which commonly goes underreported. Adequate treatment for pain in PD remains challenging, and to date, no clear guidelines for management are available.Methods:With the goal of understanding and organizing the current status of pain management in PD, we conducted a review of pharmacological and non-pharmacological treatments for pain in patients with PD. Suitable studies cataloged in PubMed and the Cochrane database up to October 31, 2019, were included prioritizing randomized controlled trials. Post-hoc analyses and open-label studies were also included.Results:Treatment with levodopa increases pain thresholds in patients with PD. Apomorphine did not have similar efficacy. Duloxetine provided benefit in an open-label trial. Oxycodone-naloxone PR did not have a significant improvement in pain, but per-protocol analysis showed a reduction in pain when adherence was strong. Rotigotine patch had numerical improvement on pain scales with no statistical significance. Safinamide significantly improved the “bodily discomfort” domain in the PDQ-39 questionnaire. Botulinum toxin A had a non-significant signal toward improving dystonic limb pain in PD. DBS to the subthalamic nucleus may modulate central pain thresholds, and a pilot study of cranioelectric therapy warrants future research in the area.Conclusion:After optimizing dopaminergic therapy, understanding the type of pain a patient is experiencing is essential to optimizing pain control in PD. While recommendations can be made regarding the treatment options in each domain, evidence remains weak and future randomized controlled studies are needed.

scholarly journals Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

2021 ◽  
pp. 154596832110231
Author(s):  
Kishoree Sangarapillai ◽  
Benjamin M. Norman ◽  
Quincy J. Almeida
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trial ◽  
Repeated Measures ◽  
Rating Scale ◽  
Controlled Trial ◽  
Motor Symptoms ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Double Blinded

Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson’s disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.

scholarly journals Foetal Cell Transplantation for Parkinson’s Disease: Focus on Graft-Induced Dyskinesia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Elisabetta Tronci ◽  
Camino Fidalgo ◽  
Manolo Carta
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cell Transplantation ◽  
Open Label ◽  
Double Blind ◽  
Clinical Investigations ◽  
Serotonin Neurons ◽  
Ventral Mesencephalic ◽  
Preclinical And Clinical Studies ◽  
Foetal Cell

Transplantation of dopamine- (DA-) rich foetal ventral mesencephalic cells emerged as a promising therapy for Parkinson’s disease (PD), as it allowed significant improvement of motor symptoms in several PD patients in open-label studies. However, double-blind clinical trials have been largely disappointing. The general agreement in the field is that the lack of standardization of tissue collection and preparation, together with the absence of postsurgical immunosuppression, played a key role in the failure of these studies. Moreover, a further complication that emerged in previous studies is the appearance of the so-called graft-induced dyskinesia (GID), in a subset of grafted patients, which resembles dyskinesia induced by L-DOPA but in the absence of medication. Preclinical evidence pointed to the serotonin neurons as possible players in the appearance of GID. In agreement, clinical investigations have shown that grafted tissue may contain a large number of serotonin neurons, in the order of half of the DA cells; moreover, the serotonin 5-HT1A receptor agonist buspirone has been found to produce significant dampening of GID in grafted patients. In this paper, we will review the recent preclinical and clinical studies focusing on cell transplantation for PD and on the mechanisms underlying GID.

The oasis (opicapone in sleep disorder) study in Parkinson's disease: Design and rationale of an open-label, single-arm, pilot trial

2021 ◽  
Vol 429 ◽  
pp. 119430
Author(s):  
Raquel Costa ◽  
Claudia Trenkwalder ◽  
Joaquim Ferreira ◽  
Diogo Magalhães ◽  
José Rocha ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorder ◽  
Pilot Trial ◽  
Open Label
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