Болезнь Паркинсона (БП) – широко распространенное нейродегенеративное заболевание, характеризующееся двигательными симптомами и рядом немоторных проявлений, одним из наиболее частых и дезадаптирующих среди них является боль. Боль испытывают около 40–70% пациентов с БП, что превышает частоту в общей популяции. Болевой синдром оказывает большое негативное влияние на общее состояние пациента, его качество жизни и требует отдельного подхода к диагностике и терапии. В статье описываются этиологические и патогенетические аспекты боли при БП, ее классификация и принципы терапии.
Parkinson's disease (PD) is a widespread neurodegenerative disease characterized by motor symptoms and a number of non-motor manifestations, one of the most frequent and maladaptive of them is pain. Pain affects about 40–70% of patients with BP, which exceeds the frequency in the general population. Pain syndrome has a great negative impact on the general condition of the patient, his quality of life, and requires a separate approach to diagnosis and therapy. The article describes the etiological and pathogenetic aspects of pain in PD, its classification and the principles of therapy.
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4. Hely MA, Reid WG, Adena MA et al. The Sydney multicenter study of Parkinson′s disease: the inevitability of dementia at 20 years. Mov Disord 2008; 6: 837–44.
5. Пилипович А.А. Болезнь Паркинсона: характеристика, симптомы, фармакотерапия. Новая аптека. 2009; 9: 26–30. / Pilipovich A.A. Bolezn' Parkinsona: kharakteristika, simptomy, farmakoterapiia. Novaia apteka. 2009; 9: 26–30. [in Russian]
6. Ziemssen T, Reichmann H. Treatment of dysautonomia in extrapyramidal disorders. Ther Adv Neurol Disord 2010; 1: 53–67.
7. Buzas B, Max MB. Pain in Parkinson disease. Neuroljgy 2004; 62: 2156–7.
8. Lee MA, Walker RW, Hildreth TG et al. A survey of pain in idiopathic Parkinson′s disease. J Pain Symptom Manage 2006; 32: 462–9.
9. Skogar O, Lokk J. Pain management in patients with Parkinson's disease: challenges and solutions. J Multidiscip Healthc 2016; 9: 469–79.
10. Nègre-Pagès L, Regragui W, Bouhassira D et al. Chronic pain in Parkinson's disease: the cross-sectional French DoPaMiPsurvey. Mov Disord 2008; 10: 1361–9.
11. Lee MA, Walker RW, Hildreth TJ, Prentice WM. A survey of pain in idiopathic Parkinson's disease. J Pain Symptom Manage 2006; 5: 462–9.
12. Defazio G, Berardelli A, Fabbrini G et al. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol 2008; 9: 1191–4.
13. Beiske AG, Loge JH, Rønningen A, Svensson E. Pain in Parkinson's disease: Prevalence and characteristics. Pain 2009; 141 (1–2): 173–7.
14. Lin XJ, Yu N, Lin XG et al. A clinical survey of pain in Parkinson's disease in Eastern China. Int Psychogeriatr 2016; 2: 283–9.
15. Wasner G, Deuschl G. Pains in Parkinson disease – many syndromes under one umbrella. Nat Rev Neurol 2012; 5: 284–94.
16. Махнев С.О., Левин О.С. Хронические болевые синдромы при болезни. Паркинсона. Журн. неврологии и психиатрии им. С.С.Корсакова. 2013; 8 (2). / Makhnev S.O., Levin O.S. Khronicheskie bolevye sindromy pri bolezni. Parkinsona. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2013; 8 (2). [in Russian]
17. Burke AL, Mathias JL, Denson LA. Psychological functioning of people living with chronic pain: a meta-analytic review. Br J Clin Psychol 2015; 3: 345–60.
18. Fil A, Cano-de-la-Cuerda R, Muñoz-Hellín E et al. Pain in Parkinson disease: a review of the literature. Parkinsonism Relat Disord 2013; 3: 285–94.
19. Defazio G, Gigante A, Mancino P, Tinazzi M. The epidemiology of pain in Parkinson's disease. J Neural Transm (Vienna) 2013; 4: 583–6.
20. Zhang LM, Chen YQ, Li WJ et al. Association between mutations of SCN9A gene and pain related to Parkinsonism. 2013; 1: 17–20.
21. Greenbaum L, Tegeder I, Barhum Y et al. Contribution of genetic variants to pain susceptibility in Parkinson disease. Eur J Pain 2012; 9: 1243–50.
22. Пилипович А. Депрессия при болезни Паркинсона. Врач. 2012; 9: 60–5. / Pilipovich A. Depressiia pri bolezni Parkinsona. Vrach. 2012; 9: 60–5. [in Russian]
23. De Sales Coriolano MDGW, de Siqueira Balbino JM, da Silva BRV et al. Pain characterization in patients with Parkinson's disease. Revista Dor 2014; 2: 78–82.
24. Ford B. Pain in Parkinson's disease. Clin Neurosci 1998; 2: 63–72.
25. Young Blood MR, Ferro MM, Munhoz RP et al. Classification and Characteristics of Pain Associated with Parkinson's Disease. Parkinsons Dis 2016; 6067132.
26. Ford B. Pain in Parkinson's disease. Mov Disord 2010; 25 (Suppl. 1): 98–103.
27. Cury RG, Galhardoni R, Fonoff ET et al. Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease. Neurology 2014; 16: 1403–9.
28. Ford B, Louis ED, Greene P, Fahn S. Oral and genital pain syndromes in Parkinson's disease. Mov Disord 1996; 4: 421–6.
29. Factor SA, Weiner WJ, editors. Parkinson's Disease: Diagnosis and Clinical Management. New York: Demos Medical Publishing, 2002.
30. Jancovic J, Nour F. Respiratory dyskinesias in Parkinson's disease. Neurology 1986; 36: 303–4.
31. Halliday GH, Barker RA, Rowe DB. Non-dopamine lesions in Parkinson’s disease. Oxford University Press, 2011.
32. Javoy-Agid F, Agid Y. Is the mesocortical dopaminergic system involved in Parkinson disease? Neurology 1980; 12: 1326–30.
33. Rana AQ, Siddiqui I, Mosabbir A et al. Association of pain, Parkinson's disease, and restless legs syndrome. J Neurol Sci 2013; 327 (1–2): 32–4.
34. Letro GH, Quagliato EMAB, Viana MA. Pain in Parkinson's Disease. Arq Neuropsiquiatr 2009; 67: 585–90.
35. Brefel-Courbon C, Payoux P, Thalamas C et al. Effect of levodopa on pain threshold in Parkinson's disease: a clinical and positron emission tomography study. Mov Disord 2005; 12: 1557–63.
36. Juri C, Rodriguez-Oroz M, Obeso JA. The pathophysiological basis of sensory disturbances in Parkinson's disease. J Neurol Sci 2010; 289 (1–2): 60–5.
37. Schestatsky P, Kumru H, Valls-Solé J et al. Neurophysiologic study of central pain in patients with Parkinson disease. Neurology 2007; 23: 2162–9.
38. Tison F, Wenning GK, Volonte MA et al. Pain in multiple system atrophy. J Neurol 1996; 2: 153–6.
39. Mylius V, Engau I, Teepker M et al. Pain sensitivity and descending inhibition of pain in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2009; 1: 24–8.
40. Conte A, Khan N, Defazio G et al. Pathophysiology of somatosensory abnormalities in Parkinson disease. Nat Rev Neurol 2013; 9 (12): 687–97.
41. Nolano M, Provitera V, Estraneo A et al. Sensory deficit in Parkinson's disease: evidence of a cutaneous denervation. Brain 2008; 131 (Pt 7): 1903–11.
42. Scherder E, Wolters E, Polman C et al. Pain in Parkinson's disease and multiple sclerosis: its relation to the medial and lateral pain systems. Neurosci Biobehav Rev 2005; 7: 1047–56.
43. Бобков А.В. Особенности болевого синдрома и полиневропатии при болезни Паркинсона. Автореф. дис. … канд. мед. наук. СПб.: 2014. / Bobkov A.V. Osobennosti bolevogo sindroma i polinevropatii pri bolezni Parkinsona. Avtoref. dis. … kand. med. nauk. SPb.: 2014. [in Russian]
44. Storch A, Schneider CB, Wolz M et al. Nonmotor fluctuations in Parkinson disease: severity and correlation with motor complications. Neurology 2013; 80 (9): 800–9.
45. Aquino CC, Fox SH. Clinical spectrum of levodopa-induced complications. Mov Disord 2015; 1: 80–9.
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1. Vorob'eva O.V., Pilipovich A.A. Bolezn' Parkinsona v fokuse vnimaniia vracha obshchei praktiki. Vestn. semeinoi meditsiny. 2011; 3: 34–9. [in Russian]
2. Levin O.S., Fedorova N.V. Bolezn' Parkinsona. 3-e izd., M.: MEDpress-inform, 2012. [in Russian]
3. Golubev V.L., Pilipovich A.A. Terminal'nye stadii bolezni Parkinsona. Lechenie nervnykh boleznei. 2008; 1: 3–11. [in Russian]
4. Hely MA, Reid WG, Adena MA et al. The Sydney multicenter study of Parkinson′s disease: the inevitability of dementia at 20 years. Mov Disord 2008; 6: 837–44.
5. Pilipovich A.A. Bolezn' Parkinsona: kharakteristika, simptomy, farmakoterapiia. Novaia apteka. 2009; 9: 26–30. [in Russian]
6. Ziemssen T, Reichmann H. Treatment of dysautonomia in extrapyramidal disorders. Ther Adv Neurol Disord 2010; 1: 53–67.
7. Buzas B, Max MB. Pain in Parkinson disease. Neuroljgy 2004; 62: 2156–7.
8. Lee MA, Walker RW, Hildreth TG et al. A survey of pain in idiopathic Parkinson′s disease. J Pain Symptom Manage 2006; 32: 462–9.
9. Skogar O, Lokk J. Pain management in patients with Parkinson's disease: challenges and solutions. J Multidiscip Healthc 2016; 9: 469–79.
10. Nègre-Pagès L, Regragui W, Bouhassira D et al. Chronic pain in Parkinson's disease: the cross-sectional French DoPaMiPsurvey. Mov Disord 2008; 10: 1361–9.
11. Lee MA, Walker RW, Hildreth TJ, Prentice WM. A survey of pain in idiopathic Parkinson's disease. J Pain Symptom Manage 2006; 5: 462–9.
12. Defazio G, Berardelli A, Fabbrini G et al. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol 2008; 9: 1191–4.
13. Beiske AG, Loge JH, Rønningen A, Svensson E. Pain in Parkinson's disease: Prevalence and characteristics. Pain 2009; 141 (1–2): 173–7.
14. Lin XJ, Yu N, Lin XG et al. A clinical survey of pain in Parkinson's disease in Eastern China. Int Psychogeriatr 2016; 2: 283–9.
15. Wasner G, Deuschl G. Pains in Parkinson disease – many syndromes under one umbrella. Nat Rev Neurol 2012; 5: 284–94.
16. Makhnev S.O., Levin O.S. Khronicheskie bolevye sindromy pri bolezni. Parkinsona. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2013; 8 (2). [in Russian]
17. Burke AL, Mathias JL, Denson LA. Psychological functioning of people living with chronic pain: a meta-analytic review. Br J Clin Psychol 2015; 3: 345–60.
18. Fil A, Cano-de-la-Cuerda R, Muñoz-Hellín E et al. Pain in Parkinson disease: a review of the literature. Parkinsonism Relat Disord 2013; 3: 285–94.
19. Defazio G, Gigante A, Mancino P, Tinazzi M. The epidemiology of pain in Parkinson's disease. J Neural Transm (Vienna) 2013; 4: 583–6.
20. Zhang LM, Chen YQ, Li WJ et al. Association between mutations of SCN9A gene and pain related to Parkinsonism. 2013; 1: 17–20.
21. Greenbaum L, Tegeder I, Barhum Y et al. Contribution of genetic variants to pain susceptibility in Parkinson disease. Eur J Pain 2012; 9: 1243–50.
22. Pilipovich A. Depressiia pri bolezni Parkinsona. Vrach. 2012; 9: 60–5. [in Russian]
23. De Sales Coriolano MDGW, de Siqueira Balbino JM, da Silva BRV et al. Pain characterization in patients with Parkinson's disease. Revista Dor 2014; 2: 78–82.
24. Ford B. Pain in Parkinson's disease. Clin Neurosci 1998; 2: 63–72.
25. Young Blood MR, Ferro MM, Munhoz RP et al. Classification and Characteristics of Pain Associated with Parkinson's Disease. Parkinsons Dis 2016; 6067132.
26. Ford B. Pain in Parkinson's disease. Mov Disord 2010; 25 (Suppl. 1): 98–103.
27. Cury RG, Galhardoni R, Fonoff ET et al. Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease. Neurology 2014; 16: 1403–9.
28. Ford B, Louis ED, Greene P, Fahn S. Oral and genital pain syndromes in Parkinson's disease. Mov Disord 1996; 4: 421–6.
29. Factor SA, Weiner WJ, editors. Parkinson's Disease: Diagnosis and Clinical Management. New York: Demos Medical Publishing, 2002.
30. Jancovic J, Nour F. Respiratory dyskinesias in Parkinson's disease. Neurology 1986; 36: 303–4.
31. Halliday GH, Barker RA, Rowe DB. Non-dopamine lesions in Parkinson’s disease. Oxford University Press, 2011.
32. Javoy-Agid F, Agid Y. Is the mesocortical dopaminergic system involved in Parkinson disease? Neurology 1980; 12: 1326–30.
33. Rana AQ, Siddiqui I, Mosabbir A et al. Association of pain, Parkinson's disease, and restless legs syndrome. J Neurol Sci 2013; 327 (1–2): 32–4.
34. Letro GH, Quagliato EMAB, Viana MA. Pain in Parkinson's Disease. Arq Neuropsiquiatr 2009; 67: 585–90.
35. Brefel-Courbon C, Payoux P, Thalamas C et al. Effect of levodopa on pain threshold in Parkinson's disease: a clinical and positron emission tomography study. Mov Disord 2005; 12: 1557–63.
36. Juri C, Rodriguez-Oroz M, Obeso JA. The pathophysiological basis of sensory disturbances in Parkinson's disease. J Neurol Sci 2010; 289 (1–2): 60–5.
37. Schestatsky P, Kumru H, Valls-Solé J et al. Neurophysiologic study of central pain in patients with Parkinson disease. Neurology 2007; 23: 2162–9.
38. Tison F, Wenning GK, Volonte MA et al. Pain in multiple system atrophy. J Neurol 1996; 2: 153–6.
39. Mylius V, Engau I, Teepker M et al. Pain sensitivity and descending inhibition of pain in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2009; 1: 24–8.
40. Conte A, Khan N, Defazio G et al. Pathophysiology of somatosensory abnormalities in Parkinson disease. Nat Rev Neurol 2013; 9 (12): 687–97.
41. Nolano M, Provitera V, Estraneo A et al. Sensory deficit in Parkinson's disease: evidence of a cutaneous denervation. Brain 2008; 131 (Pt 7): 1903–11.
42. Scherder E, Wolters E, Polman C et al. Pain in Parkinson's disease and multiple sclerosis: its relation to the medial and lateral pain systems. Neurosci Biobehav Rev 2005; 7: 1047–56.
43. Bobkov A.V. Osobennosti bolevogo sindroma i polinevropatii pri bolezni Parkinsona. Avtoref. dis. … kand. med. nauk. SPb.: 2014. [in Russian]
44. Storch A, Schneider CB, Wolz M et al. Nonmotor fluctuations in Parkinson disease: severity and correlation with motor complications. Neurology 2013; 80 (9): 800–9.
45. Aquino CC, Fox SH. Clinical spectrum of levodopa-induced complications. Mov Disord 2015; 1: 80–9.
Авторы
А.А.Пилипович
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 aapilipovich@mail.ru
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A.A.Pilipovich
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2 aapilipovich@mail.ru