Journal article
The potential role of chronic pain and the polytrauma clinical triad in predicting prodromal PD: A cross-sectional study of U.S. Veterans
Clinical parkinsonism & related disorders, Vol.10, p.100253
01/01/2024
DOI: 10.1016/j.prdoa.2024.100253
PMCID: PMC11059454
PMID: 38689822
Abstract
•Chronic pain is associated with REM sleep Behavior Disorder and prodromal Parkinson disease.•This association is even stronger when comorbid with PTSD and TBI.•Chronic pain and PTSD/TBI severity correlate with prodromal Parkinson disease.
The research criteria for prodromal Parkinson disease (pPD) depends on prospectively validated clinical inputs with large effect sizes and/or high prevalence. Neither traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), nor chronic pain are currently included in the calculator, despite recent evidence of association with pPD. These conditions are widely prevalent, co-occurring, and already known to confer risk of REM behavior disorder (RBD) and PD. Few studies have examined PD risk in the context of TBI and PTSD; none have examined chronic pain. This study aimed to measure the risk of pPD caused by TBI, PTSD, and chronic pain.
216 US Veterans were enrolled who had self-reported recurrent or persistent pain for at least three months. Of these, 44 met criteria for PTSD, 39 for TBI, and 41 for all three conditions. Several pain, sleep, affective, and trauma questionnaires were administered. Participants’ history of RBD was determined via self-report, with a subset undergoing confirmatory video polysomnography.
A greater proportion of Veterans with chronic pain met criteria for RBD (36 % vs. 10 %) and pPD (18.0 % vs. 8.3 %) compared to controls. Proportions were increased in RBD (70 %) and pPD (27 %) when chronic pain co-occurred with TBI and PTSD. Partial effects were seen with just TBI or PTSD alone. When analyzed as continuous variables, polytrauma symptom severity correlated with pPD probability (r = 0.28, P = 0.03).
These data demonstrate the potential utility of chronic pain, TBI, and PTSD in the prediction of pPD, and the importance of trauma-related factors in the pathogenesis of PD.
Details
- Title: Subtitle
- The potential role of chronic pain and the polytrauma clinical triad in predicting prodromal PD: A cross-sectional study of U.S. Veterans
- Creators
- Lee E. Neilson - Mental Illness Research, Education and Clinical CentersNadir M. Balba - Oregon Health & Science UniversityJonathan E. Elliott - VA Portland Health Care SystemGregory D. Scott - Oregon Health & Science UniversityScott D. Mist - Oregon Health & Science UniversityMatthew P. Butler - Oregon Health & Science UniversityMary M. Heinricher - Oregon Health & Science UniversityMiranda M. Lim - Oregon Health & Science University
- Resource Type
- Journal article
- Publication Details
- Clinical parkinsonism & related disorders, Vol.10, p.100253
- DOI
- 10.1016/j.prdoa.2024.100253
- PMID
- 38689822
- PMCID
- PMC11059454
- NLM abbreviation
- Clin Park Relat Disord
- ISSN
- 2590-1125
- eISSN
- 2590-1125
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 01/01/2024
- Academic Unit
- Neurology
- Record Identifier
- 9985089126102771
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