{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:31:16Z","timestamp":1790767876890,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPD"],"published-print":{"date-parts":[[2020,10,27]]},"abstract":"<jats:p>Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson\u2019s disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson\u2019s Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (H&amp;Y) stage, King\u2019s Parkinson\u2019s Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman\u2019s rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and H&amp;Y stage &gt;2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways.<\/jats:p>","DOI":"10.3233\/jpd-202088","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T13:56:08Z","timestamp":1601646968000},"page":"1817-1825","source":"Crossref","is-referenced-by-count":34,"title":["A Dual Centre Study of Pain in Parkinson\u2019s Disease and Its Relationship with Other Non-Motor Symptoms"],"prefix":"10.1177","volume":"10","author":[{"given":"Pritha","family":"Ghosh","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical Faculty Associates, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Imbriani","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy"},{"name":"IRCCS Fondazione Santa Lucia, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Caputi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Natoli","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Schirinzi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Di Lazzaro","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Covington","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Associates, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Associates, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yekaterina","family":"Salnikova","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Associates, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Rukavina","sequence":"additional","affiliation":[{"name":"King\u2019s College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, United Kingdom"},{"name":"Parkinsons Foundation Centre of Excellence, King\u2019s College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ray Chaudhuri","sequence":"additional","affiliation":[{"name":"King\u2019s College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, United Kingdom"},{"name":"Parkinsons Foundation Centre of Excellence, King\u2019s College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pisani","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy"},{"name":"IRCCS Fondazione Santa Lucia, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JPD-202088_ref1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/mds.21813","article-title":"Nonmotor symptoms as presenting complaints in Parkinson\u2019s disease: A clinicopathological study","volume":"23","author":"O\u2019Sullivan","year":"2008","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref2","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1002\/mds.26077","article-title":"The onset of nonmotor symptoms in Parkinson\u2019s disease (the ONSET PD study)","volume":"30","author":"Pont-Sunyer","year":"2015","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref3","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/WCO.0000000000000711","article-title":"Pain in Parkinson\u2019s disease: New concepts in pathogenesis and treatment","volume":"32","author":"Rukavina","year":"2019","journal-title":"Curr Opin Neurol"},{"key":"10.3233\/JPD-202088_ref4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.parkreldis.2018.06.001","article-title":"A detailed clinical study of pain in 1957 participants with early\/moderate Parkinson\u2019s disease","volume":"56","author":"Silverdale","year":"2018","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202088_ref5","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.parkreldis.2019.04.025","article-title":"How to diagnose parkinsonian central pain?","volume":"64","author":"Marques","year":"2019","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202088_ref6","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1007\/s00415-017-8426-y","article-title":"Pain in Parkinson disease: A cross-sectional survey of its prevalence, specifics, and therapy","volume":"64","author":"Buhmann","year":"2017","journal-title":"J Neurol"},{"key":"10.3233\/JPD-202088_ref7","doi-asserted-by":"crossref","first-page":"469","DOI":"10.2147\/JMDH.S105857","article-title":"Pain management in patients with Parkinson\u2019s disease: Challenges and solutions","volume":"9","author":"Skogar","year":"2016","journal-title":"J Multidiscip Healthc"},{"key":"10.3233\/JPD-202088_ref8","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1002\/mdc3.12469","article-title":"Clinical determinants of Parkinson\u2019s disease-associated pain using the King\u2019s Parkinson\u2019s Disease Pain Scale","volume":"4","author":"Rodr\u00edguez-Violante","year":"2017","journal-title":"Mov Disord Clin Pract"},{"key":"10.3233\/JPD-202088_ref9","doi-asserted-by":"crossref","first-page":"e0136541","DOI":"10.1371\/journal.pone.0136541","article-title":"Pain in Parkinson\u2019s disease: A cross-sectional study of its prevalence, types, and relationship to depression and quality of life","volume":"10","author":"Valkovic","year":"2015","journal-title":"PLoS One"},{"key":"10.3233\/JPD-202088_ref10","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1002\/mds.26826","article-title":"Anatomical and functional correlates of persistent pain in Parkinson\u2019s disease","volume":"31","author":"Polli","year":"2016","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref11","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1007\/s00415-015-7823-3","article-title":"Efficacy and safety profile of prolonged release oxycodone in combination with naloxone (OXN PR) in Parkinson\u2019s disease patients with chronic pain","volume":"262","author":"Madeo","year":"2015","journal-title":"J Neurol"},{"key":"10.3233\/JPD-202088_ref12","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/S1474-4422(15)00243-4","article-title":". Prolonged-release oxycodone-naloxone for treatment of severe pain in patients with Parkinson\u2019s disease (PANDA): A double-blind, randomised, placebo-controlled trial","volume":"14","author":"Trenkwalder","year":"2015","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-202088_ref13","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/mds.27602","article-title":"Update on treatments for nonmotor symptoms of Parkinson\u2019s disease-an evidence-based medicine review","volume":"34","author":"Seppi","year":"2019","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref14","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.pnpbp.2017.10.010","article-title":"Chronic pain and pain processing in Parkinson\u2019s disease","volume":"87","author":"Blanchet","year":"2018","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"10.3233\/JPD-202088_ref15","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/mdc3.12694","article-title":"Relationship of nocturnal sleep dysfunction and pain subtypes in Parkinson\u2019s disease","volume":"6","author":"Martinez-Martin","year":"2019","journal-title":"Mov Disord Clin Pract"},{"key":"10.3233\/JPD-202088_ref16","first-page":"3067426","article-title":"Dysautonomia differentially influences the effect of affective pain perception on quality of life in Parkinson\u2019s disease patients","volume":"2016","author":"Rada","year":"2016","journal-title":"Parkinsons Dis"},{"issue":"Suppl 1","key":"10.3233\/JPD-202088_ref17","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.parkreldis.2015.09.027","article-title":"Non motor subtypes and Parkinson\u2019s disease","volume":"22","author":"Sauerbier","year":"2016","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202088_ref18","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1002\/mds.26270","article-title":"Non Motor PD Study Group: King\u2019s Parkinson\u2019s disease pain scale, the first scale for pain in PD: An international validation","volume":"30","author":"Chaudhuri","year":"2015","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref19","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref20","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/ejp.1090","article-title":"Chronic widespread pain prevalence in the general population: A systematic review","volume":"22","author":"Andrews","year":"2018","journal-title":"Eur J Pain"},{"key":"10.3233\/JPD-202088_ref21","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2016.1464","article-title":"CDC guideline for prescribing opioids for chronic pain\u2013United States","volume":"315","author":"Dowell","year":"2016","journal-title":"JAMA"},{"key":"10.3233\/JPD-202088_ref22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clineuro.2017.05.022","article-title":"Disability from pain directly correlated with depression in Parkinson\u2019s disease","volume":"160","author":"Rana","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"10.3233\/JPD-202088_ref23","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.smrv.2015.03.004","article-title":"Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies","volume":"26","author":"Bjurstrom","year":"2016","journal-title":"Sleep Med Rev"},{"key":"10.3233\/JPD-202088_ref24","doi-asserted-by":"crossref","first-page":"767","DOI":"10.3389\/fneur.2018.00767","article-title":"Neuroimaging of sleep disturbances in movement disorders","volume":"9","author":"Yousaf","year":"2018","journal-title":"Front Neurol"},{"key":"10.3233\/JPD-202088_ref25","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1002\/mds.23744","article-title":"Does cardiovascular autonomic dysfunction contribute to fatigue in Parkinson\u2019s disease?","volume":"26","author":"Nakamura","year":"2011","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref26","doi-asserted-by":"crossref","first-page":"3434","DOI":"10.1093\/brain\/awq268","article-title":"Fatigue in Parkinson\u2019s disease is linked to striatal and limbic serotonergic dysfunction","volume":"133","author":"Pavese","year":"2010","journal-title":"Brain"},{"key":"10.3233\/JPD-202088_ref27","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1212\/01.wnl.0000295669.12443.d3","article-title":"Neurophysiologic study of central pain in patients with Parkinson disease","volume":"69","author":"Schestatsky","year":"2007","journal-title":"Neurology"},{"key":"10.3233\/JPD-202088_ref28","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1002\/mds.26048","article-title":"Norepinephrine deficiency in Parkinson\u2019s disease: The case for noradrenergic enhancement","volume":"29","author":"Espay","year":"2014","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref29","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/mds.27344","article-title":"Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies","volume":"33","author":"Palma","year":"2018","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202088_ref30","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1136\/jnnp-2011-300444","article-title":"Muscle ischaemia in patients with orthostatic hypotension assessed by velocity recovery cycles","volume":"82","author":"Humm","year":"2011","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JPD-202088_ref31","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1212\/WNL.59.3.408","article-title":"Nonmotor fluctuations in Parkinson\u2019s disease: Frequent and disabling","volume":"59","author":"Witjas","year":"2002","journal-title":"Neurology"},{"key":"10.3233\/JPD-202088_ref32","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jns.2011.06.047","article-title":"Mechanisms of orthostatic hypotension and supine hypertension in Parkinson disease","volume":"310","author":"Sharabi","year":"2011","journal-title":"J Neurol Sci"},{"key":"10.3233\/JPD-202088_ref33","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.parkreldis.2008.10.001","article-title":"Correlation between changes in CSF dopamine turnover and development of dyskinesia in Parkinson\u2019s disease","volume":"15","author":"Lunardi","year":"2009","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202088_ref34","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1007\/s00702-017-1757-0","article-title":"Nonmotor fluctuations: Phenotypes, pathophysiology, management, and open issues","volume":"124","author":"Classen","year":"2017","journal-title":"J Neural Transm (Vienna)"}],"container-title":["Journal of Parkinson's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JPD-202088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:48:31Z","timestamp":1777610911000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JPD-202088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":34,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3233\/jpd-202088","relation":{},"ISSN":["1877-7171","1877-718X"],"issn-type":[{"value":"1877-7171","type":"print"},{"value":"1877-718X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,27]]}}}