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

Authors

  • Estelle Dellapina MSc,

    Corresponding author
    1. Inserm, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    2. Université de Toulouse, UPS, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    • Inserm U825, Pavillon Riser, CHU Purpan, 31059 Toulouse, France
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  • Angélique Gerdelat-Mas MD,

    1. Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
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  • Fabienne Ory-Magne MD,

    1. Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
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  • Laure Pourcel MSc,

    1. Unité de Pharmacoépidémiologie, Faculté de médecine, Toulouse, France
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  • Monique Galitzky MD,

    1. Inserm, Centre d'Investigation Clinique, CHU Purpan, Toulouse, France
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  • Fabienne Calvas MD,

    1. Inserm, Centre d'Investigation Clinique, CHU Purpan, Toulouse, France
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  • Marion Simonetta-Moreau MD, PhD,

    1. Inserm, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    2. Université de Toulouse, UPS, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    3. Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
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  • Claire Thalamas MD,

    1. Inserm, Centre d'Investigation Clinique, CHU Purpan, Toulouse, France
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  • Pierre Payoux MD, PhD,

    1. Inserm, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    2. Université de Toulouse, UPS, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
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  • Christine Brefel-Courbon MD

    1. Inserm, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    2. Université de Toulouse, UPS, Imagerie cérébrale et handicaps neurologiques, Toulouse, France
    3. Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
    4. Service de Pharmacologie Clinique, Faculté de médecine, Toulouse, France
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  • Potential conflict of interest: Nothing to report.

Abstract

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 (Hmath imageO 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.

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