Apomorphine effect on pain threshold in Parkinson's disease: A clinical and positron emission tomography study

• Published in: Movement disorders Vol. 26; no. 1; pp. 153 - 157
• Main Authors: Dellapina, Estelle, Gerdelat-Mas, Angélique, Ory-Magne, Fabienne, Pourcel, Laure, Galitzky, Monique, Calvas, Fabienne, Simonetta-Moreau, Marion, Thalamas, Claire, Payoux, Pierre, Brefel-Courbon, Christine
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.01.2011; Wiley
• Subjects: Aged; Antiparkinson Agents - pharmacology; Antiparkinson Agents - therapeutic use; apomorphine; Apomorphine - pharmacology; Apomorphine - therapeutic use; Biological and medical sciences; Cerebral Cortex - diagnostic imaging; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Double-Blind Method; Female; Humans; H 215O positron emission tomography; Male; Medical sciences; Middle Aged; Neuralgia - diagnosis; Neuralgia - etiology; Neurology; Oxygen Isotopes; pain threshold; Pain Threshold - drug effects; Parkinson Disease - complications; Parkinson Disease - diagnostic imaging; Parkinson Disease - drug therapy; Parkinson Disease - pathology; Parkinson's disease; Positron-Emission Tomography - methods; Nervous system diseases; Parkinson's disease; Parkinson disease; H; Cerebral disorder; O positron emission tomography; Pain; apomorphine; Central nervous system disease; Degenerative disease; Positron emission tomography; pain threshold; Extrapyramidal syndrome; Emission tomography
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.23406

Patients with Parkinson's disease (PD) frequently experience pain that could be in part due to central modification of nociception. In this randomized controlled double blind study, we compared the effect of apomorphine versus placebo on pain thresholds and pain‐induced cerebral activity in 25 patients with PD. Subjective pain threshold (using thermal stimulation, thermotest), objective pain threshold (nociceptive flexion reflex), and cerebral activity (H 215O PET) during noxious and innocuous stimulations were performed. Neither subjective nor objective pain thresholds nor pain activation profile were modified by apomorphine compared with placebo in 25 PD patients. Apomorphine has no effect on pain processing in PD. We suggest that other monoamine systems than dopaminergic system could be involved. © 2010 Movement Disorder Society.