The Lancet. NeurologyReview
undefined Apr 2025
With over 10 million people affected worldwide, Parkinson's disease is the fastest-growing neurological disorder.
More than two-thirds of people with Parkinson's disease live with chronic pain, which can manifest in various stages of the disease, substantially affecting daily activities and quality of life.
The Parkinson's disease Pain Classification System overcomes the limitations of previous classification systems by distinguishing between pain related to Parkinson's disease and unrelated pain, while also incorporating clinical and pathophysiological (mechanistic) descriptors such as nociceptive, neuropathic, and nociplastic pain.
This system provides a framework for accurate diagnosis and mechanism-based therapy.
Alongside the appropriate classification of pain, consideration of treatment approaches that include non-invasive (pharmacological and non-pharmacological) and invasive strategies tailored to specific types of pain will refine and inform research trials and clinical practice when it comes to treating pain in Parkinson's disease.
Declaration of interests VM declares grants from Parkinson Switzerland, the Dr Wilhelm Hurka Foundation, BIAL, and Zambon; honoraria from Abbvie and BIAL for presentations; travel compensation from Zambon. VM consulted for BIAL; is a member of the scientific board of Parkinson Switzerland; and is a member of the editorial board of the European Journal of Pain. SP-L declares grants from the Agencia de Promoción Científica, Fundación Bunge y Born, Fundación Esteban Bullrich, and Instituto Universitario Barceló. SP-L owns stocks from TeleNeuro Solutions. DCA is vice chair for the research committee of the European Federation of International Association for the Study of Pain chapters; is section editor for the European Journal of Pain; is on the advisory board of Pain Reports; is an employee of Aalborg University, Denmark; is a non-remunerated collaborator professor of University of Sao Paulo, Brazil; declares institutional investigator-initiated research grants from Cristalia, Mundipharma, St Jude Medical–Abbott Medical, Medtronic, Magventure, and Grunenthal; received remuneration for lectures for Mundipharma, GreenCare, and Magventure; received conference travel support from the Pain Center at University of Sao Paulo, Brazil, and Megventure; declares research grants from FAPESP (Fundacao de Amparo à Pesquisa do Estado de Sao Paulo), Brazil, Novo Nordisk Foundation, Neuroscience Academy Denmark (Lundbeck Foundation), Horizon Europe (Fresco4NoPain European consortium), and the European Research Council. CAA received speaker honoraria from Abbvie, Bial, Zambon, Lusofarmaco, and Ralpharma. CB-C received consultancy fees from Merz, Bial, NHC Care, and Orkyn; declares grants from the French Ministry of Health (programme hospitalier de recherche clinique), the French Ministry of Research (ANR), France Parkinson, Fondation AXA, Everpharma, Elivie, NHC Care, and Orkyn; has received honoraria for speeches from Orkyn, Novartis, and AJR Medical; and received support for attending meetings or travel from Orkyn, AJR, Abbvie, NHC Care, and Adelia. KB received research funding from Parkinson's UK. Outside of the submitted work, MT has received research funding from the Italian Ministry of Health, University of Verona, and the Verona Brain Research Foundation, and personal fees from Abbvie, Bial, Chiesi Farmaceutici, Zambon, and the Movement Disorders Society. MG has received research funding from the Italian Multiple Sclerosis Foundation and the Verona Brain Research Foundation. KB has received research funding from Parkinson's UK. All other authors declare no competing interests.
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