Incidence of pain phenotypes and co-morbidities of chronic pain in Parkinson’s Disease

Introduction: The incidence of pain in Parkinson's disease (PD) varies from 24-83% across studies and has become a well-recognized non-motor symptom of PD. Different types of pain have been noted with variability in treatment success. Treatments offered span from pharmaceutical treatments to surgical treatments such as deep brain stimulation (DBS). Treatments have reported a range of 61-92% success in treating pain symptoms of PD. To gain a better understanding of prevalence of pain in PD in real-world cases, identify treatment options (both surgical and non-surgical) for pain and PD and identify those who may respond better to treatments, we leveraged data from the electronic medical records in the TriNetX database.

Methods: To understand pain phenotypes in PD, we first explored its incidence in a large international database with electronic medical records from over 250 million patients across 80 sites (TriNetX Cambridge, MA, USA). We described demographics, co-morbid conditions, and medication differences between patients with PD and those without PD who have chronic pain. Data extracted included diagnoses, procedures, co-morbid conditions, medications, and laboratory values.

Results: Data included 4,507 patients with PD. Chronic pain was identified in 19.3% of males and 22.8% of females. This differed significantly from patients without PD who had a significantly lower incidence of 3.78% (males) and 4.76% (females). Significantly more PD patients (male and females) received tramadol, oxycodone, and neuropathic agents (including anti-depressants, anti-convulsants, pre-gabalin, and gabapentin) (p < 0.001). When examining sex-differences between groups, females with PD more often received anti-depressants (p < 0.05).

Conclusion : By understanding the incidence and impact of chronic pain in PD and its impact on patient’s well-being, we are able to develop innovative tools and approaches to improve patient outcomes. We can further investigate biomarkers to determine who may respond to DBS to help improve their chronic pain symptoms and who may need additional therapies to aid with symptom relief.