Constipation and pain in Parkinson's disease: a clinical analysis

Abstract

Parkinson's Disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms (NMS). Among NMS, constipation and pain are both highly prevalent and debilitating affecting up to 80% of PD patients and impairing their quality of life. Here, we investigated the relationship between constipation and pain in PD patients. This is a retrospective study assessing the relationship between pain and constipation in a PD patient population from a clinical database of patients attending the outpatient clinic of the movement disorders division, Neurology Unit of Policlinico Tor Vergata, in Rome. Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (H&Y) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS) and Beck Depression Inventory (BDI). Patients were further divided in two groups (Group 1, 32 patients with constipation and Group 2, 35 PD patients without constipation) ANOVA and ANCOVA analysis were used to compare the two groups. PD patients with constipation had significantly higher pain severity and pain interference, as measured by the BPI scale and higher total KPPS score, fluctuation-related pain, nocturnal pain, and radicular pain when compared to PD patients without constipation. This study highlights for the first time a possible interplay between constipation and pain in PD that deserves further investigations.

Keywords: Constipation; Non-motor symptom; Pain perception; Parkinson’s disease.

Fig. 1

The differences and average of Brief Pain Inventory (BPI) scores and King Parkinson’s pain scale (KPPS) total scores and sub-domains, represent as (Mean ± SD) in PD patients with constipation and without. ANCOVA test adjusted for H&Y staging, LEED, MDS-UPDRS-III and disease duration. The significance values are reported (*P < 0.05)

Fig. 2

The differences and average of Non-motor Symptoms Scale (NMSS) scores and sub-domains, represent as (Mean ± SD) in PD patients with constipation and without. The significance values are reported (*P < 0.05)