Factors Affecting Pain in Patients with Parkinson's Disease: a Systematic Review

Abstract

Background Pain is a common non-motor symptom in patients with Parkinson's disease (PD) , which has a serious impact on patients' quality of life. Current scholars have explored the factors influencing the occurrence of pain in patients with PD, but there is some variability in the findings. Objective To evaluate the influencing factors of pain in PD patients. Methods We searched the CNKI, Wanfang Data, VIP, SinoMed, Web of Science, PubMed, Medline, Embase and Cochrane Library databases for studies on factors influencing pain in patients with PD from database establishment to April 12, 2022. Two researchers independently conducted literature screening and relevant information extraction. We used the Agency for Healthcare Research and Quality (AHRQ) Scale and the Newcastle-Ottawa Scale (NOS) to evaluate the risk of bias in cross-sectional studies and case-control studies, respectively. We performed a descriptive analysis of all influencing factors of pain, and implemented a meta-analysis of these influencing factors using RevMan 5.3. Results Sixteen studies were finally included, with a total sample size of 2 855 cases, and 24 influencing factors of pain identified. There were two protective factors and 22 risk factors in descriptive analysis. The meta-analysis showed that, female〔OR=3.73, 95%CI (1.75, 7.96) , P=0.000 7〕, long duration of PD〔OR=1.35, 95%CI (1.15, 1.60) , P=0.000 3〕, depressed mood 〔OR=1.14, 95%CI (1.07, 1.22) , P<0.000 01〕, high UPDRS Ⅲ score〔OR=1.07, 95%CI (1.03, 1.11) , P=0.000 2〕, advanced Hoehn-Yahr stages〔OR=2.28, 95%CI (1.28, 4.04) , P=0.005〕, and high NMSS score〔OR=1.68, 95%CI (1.46, 1.93) , P<0.000 01〕 were risk factors for pain in PD patients. The GRADE analysis showed that the quality of evidence for the effects of gender and NMSS score on pain was moderate, and that for the effects of duration of PD, depressed mood and UPDRSⅢ score on pain was low, and that for the effect of Hoehn-Yahr stage on pain was very low. Conclusion Female, long duration of PD, depressed mood, motor impairment, advanced Hoehn-Yahr stages and other severe non-motor symptoms (sleep disturbance, fatigue) are risk factors for pain in PD patients, which need to be further validated by high-quality, large-sample studies in the future.

Keywords

• parkinson disease|pain|non-motor symptoms|root cause analysis|cross-sectional studies|case-control studies|systematic review