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La douleur dans la maladie de Parkinson

Pain in Parkinson’s disease

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Douleur et Analgésie

Résumé

Dans la maladie de Parkinson, la prévalence de la douleur chronique est supérieure à 60 %. Il existe des douleurs nociceptives liées aux symptômes moteurs et des douleurs neuropathiques liées à une altération des mécanismes d’intégration de la douleur. Les seuils douloureux subjectifs sont abaissés chez les parkinsoniens et associés à une activation anormale de plusieurs aires cérébrales nociceptives. L’administration de la L-Dopa élève ces seuils et diminue l’activité de ces aires cérébrales. Le traitement des douleurs parkinsoniennes est peu évalué. Un agoniste dopaminergique et un médicament opioïde pourrait diminuer la douleur. La stimulation cérébrale profonde induit un effet bénéfique.

Abstract

The prevalence of chronic pain is superior to 60% in Parkinson’s disease (PD). Nociceptive pain is related to motor symptoms and neuropathic pain can result from abnormal pain processing. The pain thresholds are lower in PD patients and associated with a hyperactivation in cerebral nociceptive areas. L-Dopa administration reduced both pain perception and cerebral hyperactivation. The treatment of pain in PD is not well-known. A dopamine agonist and an opioid drug could decrease pain and deep brain stimulation could also improve painful PD patients.

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Authors and Affiliations

  1. Service de neurologie, centre expert Parkinson, CHU Toulouse, Toulouse, France

    J. Dupouy, F. Ory-Magne & C. Brefel-Courbon

  2. INSERM, imagerie cérébrale et handicaps neurologiques, UMR 1214, Toulouse, France

    F. Ory-Magne & C. Brefel-Courbon

  3. Service de pharmacologie clinique, CHU Toulouse, Faculté de médecine, 37 allée Jules Guesde, F-31000, Toulouse, France

    C. Brefel-Courbon

Authors
  1. J. Dupouy
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  2. F. Ory-Magne
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  3. C. Brefel-Courbon
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Correspondence to C. Brefel-Courbon.

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Dupouy, J., Ory-Magne, F. & Brefel-Courbon, C. La douleur dans la maladie de Parkinson. Douleur analg 30, 3–6 (2017). https://doi.org/10.1007/s11724-016-0474-z

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  • DOI: https://doi.org/10.1007/s11724-016-0474-z

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