Dor na doença de Parkinson: intensidade, tipos e impacto na qualidade de vida

Abstract

Introduction: Pain is a highly prevalent non-motor symptom in Parkinson’s disease (PD), negatively impacting patients’ functionality and quality of life. However, the literature is scarce regarding the assessment of different types of pain in PD using specific instruments. Furthermore, measuring the impact of pain on various aspects of patients’ lives through reliable and validated tools may contribute to disease monitoring and the evaluation of therapeutic strategies. The EQ-5D-3L is widely used to assess quality of life (QoL), but its validation in PD is still necessary. Objective: To assess pain intensity and the prevalence of different types of pain in individuals with PD, investigate the association between sociodemographic and clinical factors and QoL, and evaluate the measurement properties of the EQ-5D-3L instrument. Methods: Fifty patients with a diagnosis of idiopathic PD were evaluated. Pain intensity was measured using the Numeric Rating Scale (NRS) and the King’s Parkinson’s Disease Pain Scale (KPPS), the latter also being used to determine the prevalence of pain types. Additional instruments were applied to assess: severity of PD signs and symptoms (Unified Parkinson’s Disease Rating Scale, UPDRS), fatigue (Fatigue Severity Scale, FSS), depressive symptoms (Beck Depression Inventory, BDI), functional disability (Roland-Morris Disability Questionnaire, RMDQ, and Patient-Specific Functional Scale, PSFS), and QoL (Parkinson’s Disease Questionnaire-39, PDQ-39, and EQ-5D-3L). Associations between sociodemographic and clinical factors and QoL were examined, as well as the internal consistency and construct validity of the EQ-5D-3L. Results: The sample consisted of 32 men and 18 women, with a mean age of 70.8±8.7 years and a mean disease duration of 10.8±9.7 years, mostly in early stages of PD. According to the KPPS, 49 patients (98%) reported pain, with musculoskeletal pain being the most frequent. NRS analysis indicated that women reported higher pain intensity. The lower back and lower limbs were the most affected regions. In addition to pain, depressive symptoms, fatigue, and functional disability were significantly associated with QoL, as assessed by the PDQ-39. Among the PDQ-39 domains, only the stigma domain showed a difference between men and women. The EQ-5D-3L presented a Cronbach’s alpha of 0.71, indicating acceptable internal consistency. A significant association was observed between EQ-5D-3L scores and the presence and severity of depressive symptoms, as well as the severity of PD signs and symptoms and various PDQ-39 domains. Conclusion: Pain is a highly prevalent symptom, even in the early stages of PD, and directly impacts patients’ QoL. Among the factors evaluated, depressive symptoms were most strongly associated with QoL, as indicated by both the PDQ-39 and EQ-5D-3L instruments. The EQ-5D-3L demonstrated acceptable internal consistency and good construct validity for assessing QoL in individuals with PD.