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      Pain Severity and Interference in Different Parkinson’s Disease Cognitive Phenotypes

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          Abstract

          Introduction

          Chronic pain is prevalent in idiopathic Parkinson’s disease (PD) with many individuals also experiencing cognitive deficits negatively impacting everyday life.

          Methods

          In this study, we examine differences in pain severity and interference between 113 nondemented individuals with idiopathic PD who were statistically classified as having low executive function (n=24), low memory function (n=35), no cognitive deficits (n=54). The individuals with PD were also compared to matched non-PD controls (n=64).

          Results

          PD participants with low executive function reported significantly higher pain interference (p<0.05), despite reporting similar pain severity levels compared to other phenotypes. These differences remained statistically significant, even after accounting for important confounders such as anxiety and depression (p<0.05).

          Discussion

          Pain interference in those with lower executive function may represent a target for psychosocial interventions for individuals with pain and PD.

          Related collections

          Most cited references 45

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          A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.

          The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
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            Parkinsonism: onset, progression, and mortality

             M Hoehn,  M Yahr (1967)
            Neurology, 17(5), 427-427
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              • Article: not found

              What features improve the accuracy of clinical diagnosis in Parkinson's disease: a clinicopathologic study.

              Many authorities have drawn attention to the difficulties in clinically distinguishing Parkinson's disease (PD) from other parkinsonian syndromes. We assessed the clinical features of 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic PD according to their pathologic findings. Seventy-six percent of these cases were confirmed to have PD. By using selected criteria (asymmetrical onset, no atypical features, and no possible etiology for another parkinsonian syndrome) the proportion of true PD cases identified was increased to 93%, but 32% of pathologically confirmed cases were rejected on this basis. These observations suggest that studies based on consultant diagnosis of PD, using standard diagnostic criteria, will include cases other than PD, thus distorting results from clinical trials and epidemiologic studies. The strict use of additional criteria can reduce misdiagnosis but at the cost of excluding genuine PD cases.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                jpr
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                29 December 2020
                2020
                : 13
                : 3493-3497
                Affiliations
                [1 ]Pain Research & Intervention Center of Excellence, University of Florida , Gainesville, FL, USA
                [2 ]Department of Clinical and Health Psychology, University of Florida , Gainesville, FL, USA
                [3 ]Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL, USA
                Author notes
                Correspondence: Catherine C Price ABPP/Cn Tel +1 352-273-5929 Email cep23@phhp.ufl.edu
                Article
                270669
                10.2147/JPR.S270669
                7778379
                © 2020 Cruz-Almeida et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 1, References: 45, Pages: 5
                Categories
                Original Research

                Anesthesiology & Pain management

                phenotypes, profiles, cognitive function, pain, parkinson’s disease

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