Analysis of Sensory Profiles and Modulation Mechanisms in People Living with Parkinson's Disease and Comorbid Chronic Pain

Phase

N/A

Condition

Parkinson's Disease

Healthy Volunteers

Chronic Pain

Treatment

N/A

Clinical Study ID

TX320636

Ages 50-80
All Genders
Accepts Healthy Volunteers

Study Summary

Pain is a highly prevalent symptom in Parkinson Disease (PD), often experienced before the onset of motor symptoms, and aggravating as PD progresses. Previous research reports a higher sensitivity for painful stimulation and neuropathological abnormalities in different brain regions of pain processing in patients with PD but fails to explain individual differences in pain experience in these people. Uninvestigated dysfunctionalities in pain modulation might contribute to vulnerability to pain.

We aim to characterize pain sensitivity profiles as well as pain modulatory responses involving central endogenous regulatory systems. People experiencing PD-related pain will be compared to pain-free PD participants, people living with chronic pain (CP), and healthy volunteers to reveal pain processing alterations associated with the presence or not of pain in PD and CP.

Eligibility Criteria

Inclusion

Inclusion criteria: We aim to recruit 120 participants aged 50-80 years old to participate in the study. The participants will be separated into 4 distinct groups of 30 people each:

Group 1: People living with Parkinson’s disease (diagnosed after the age of 50), between stages I and III of Hoehn and Yahr, and experiencing primarily chronic low back pain (6 months or longer).
Group 2: People living with Parkinson’s disease (diagnosed after the age of 50), between stages I and III of Hoehn and Yahr without pain.
Group 3: Community volunteers, men, and women, with no history of major neurological or psychiatric conditions., age- and sex- matched adults with chronic low back pain (6 months or longer).
Group 4: Age- and sex- matched healthy individuals with no history of chronic low back pain (pain lasting for 6 months or less).

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Exclusion

Exclusion criteria: **

People with a history of cancer, severe psychiatric disorder, alcohol- dependency, type I or II diabetes, vitamin B12 deficiency currently requiring parenteral supplementation, any neurological disease other than PD, people who score less than 22 in the Montreal Cognitive Assessment (MoCA), people living with PD categorized as non-responsive to dopaminergic treatment by their neurologist, and people who underwent general anaesthesia in the past six months.

Study Design

July 01, 2023

December 31, 2025

Study Description

We will use thermal, tactile, and pressure standardized stimulators to determine the threshold for painful and non-painful sensations. For people living with PD, we will perform this protocol both in on and off-dopaminergic medication states. Regarding pain modulation, we will study the following mechanisms: a) cognitive modulation: pain expectations will be induced with visual cues to prime participants to anticipate low, moderate, or high pain, and then tested using concordant or discordant heat stimuli; and b) conditioned pain modulation (heterotopic noxious counterirritation analgesia): contact heat pain perception (test stimuli) is tested on one hand before, during and after the immersion of the opposite hand in painfully cold water.

Specific pain processing alteration is expected in the form of hypersensitivity for gating nociceptive information and less efficient pain regulation, unique to people living with PD and with greater alteration in people living simultaneously with PD and CP than in those without pain. Understanding the vulnerability to pain in PD and providing comprehensive knowledge on possible underlying mechanisms may help improve patient care and support, and guide future research on the treatment of pain in the disease.

Connect with a study center

Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Université de Montréal
Montreal, Quebec 316
Canada
Active - Recruiting

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