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dc.contributor.authorBlanchet, Pierre J.
dc.contributor.authorBrefel-Courbon, Christine
dc.date.accessioned2017-10-27T17:27:32Z
dc.date.availableMONTHS_WITHHELD:12fr
dc.date.available2017-10-27T17:27:32Z
dc.date.issued2017-10-12
dc.identifier.urihttp://hdl.handle.net/1866/19493
dc.subjectPainfr
dc.subjectParkinson’s diseasefr
dc.subjectNociceptionfr
dc.subjectFluctuationsfr
dc.subjectDopaminefr
dc.subjectBasal gangliafr
dc.titleChronic pain and pain processing in Parkinson’s diseasefr
dc.typeArticlefr
dc.contributor.affiliationUniversité de Montréal. Faculté de médecine dentairefr
UdeM.statutProfesseur(e) / Professorfr
dc.identifier.doi10.1016/j.pnpbp.2017.10.010
dcterms.abstractPain is experienced by the vast majority of patients living with Parkinson’s disease. It is most often of nociceptive origin, but may also be ascribed to neuropathic (radicular or central) or miscellaneous sources. The recently validated King’s Parkinson’s Disease Pain Scale is based on 7 domains including musculoskeletal pain, chronic body pain (central or visceral), fluctuation-related pain, nocturnal pain, oro-facial pain, pain with discolouration/oedema/swelling, and radicular pain. The basal ganglia integrate incoming nociceptive information and contribute to coordinated motor responses in pain avoidance and nocifensive behaviors. In Parkinson’s disease, nigral and extra-nigral pathology, involving cortical areas, brainstem nuclei, and spinal cord, may contribute to abnormal central nociceptive processing in patients experiencing pain or not. The dopamine deficit lowers multimodal pain thresholds that are amenable to correction following levodopa dosing. Functional brain imaging with positron emission tomography following administration of H215O revealed abnormalities in the sensory discriminative processing of pain (insula/SII), as well as in the affective motivational processing of pain (anterior cingulate cortex, prefrontal cortex). Pain management is dependent on efforts invested in diagnostic accuracy to distinguish nociceptive from neuropathic pain. Treatment requires an integrated approach including strategies to lessen levodopa-related response fluctuations, in addition to other pharmacological and non-pharmacological options such as deep brain stimulation and rehabilitation.fr
dcterms.isPartOfurn:ISSN:1878-4216
dcterms.isPartOfurn:ISSN:0278-5846
dcterms.languageengfr
UdeM.VersionRioxxVersion acceptée / Accepted Manuscript
oaire.citationTitleProgress in neuro-psychopharmacology & biological psychiatry
oaire.citationVolume87
oaire.citationIssuepart B
oaire.citationStartPage200
oaire.citationEndPage206


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