BACKGROUND Chronic musculoskeletal pain often co-occurs with Parkinson's disease (PD); however, whether individuals with chronic pain have a higher risk of developing PD is unclear. OBJECTIVES To investigate the associations between chronic pain and incident risk of three neurodegenerative parkinsonism categories including PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). METHODS This study included 355,890 participants (mean [standard deviation] age, 56.51 [8.07] years, 48.40% male) who did not have parkinsonism at baseline from a population-based cohort. Musculoskeletal pain in the hip, neck/shoulder, back, knee, or "all over the body" was assessed. Chronic pain was defined if pain lasted ≥3 months. Participants were categorized into four groups: no chronic pain, having one or two, three or four sites, and pain "all over the body." The diagnosis of PD, MSA, and PSP used self-reports, hospital records, and death registries. Multivariable-adjusted Cox regression was performed for the analyses. RESULTS Over a median follow-up of 13.0 years, 2044 participants developed PD, 77 participants developed MSA, and 126 participants developed PSP. In multivariable analyses, there was a dose-response relationship between number of chronic pain sites and incident risk of PD (hazard ratio, 1.15; 95% confidence interval, 1.07-1.23). Participants with one or two pain sites and three or four pain sites had an 11% and 49% increased risk of developing PD, respectively. There were no associations between chronic pain and MSA or PSP. CONCLUSIONS Chronic musculoskeletal pain was independently associated with PD, suggesting that chronic pain could be used to identify individuals at risk of developing PD. © 2024 International Parkinson and Movement Disorder Society.

中文翻译：

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慢性肌肉骨骼疼痛和帕金森病发生风险：一项为期 13 年的纵向研究。


背景 慢性肌肉骨骼疼痛通常与帕金森病 （PD） 同时发生;然而，患有慢性疼痛的个体患 PD 的风险是否更高尚不清楚。目的 探讨慢性疼痛与 PD、多系统萎缩 （MSA） 和进行性核上性麻痹 （PSP） 这三种神经退行性帕金森病发生风险之间的关联。方法 本研究包括 355,890 名参与者 （平均 [标准差] 年龄，56.51 [8.07] 岁，48.40% 为男性），他们来自基于人群的队列，基线时没有帕金森综合征。评估了臀部、颈部/肩部、背部、膝盖或“全身”的肌肉骨骼疼痛。如果疼痛持续 ≥3 个月，则定义为慢性疼痛。参与者被分为四组：无慢性疼痛，有 1 或 2 个、3 或 4 个部位，以及“全身”疼痛。PD、MSA 和 PSP 的诊断使用自我报告、医院记录和死亡登记。对分析进行多变量调整的 Cox 回归。结果 在中位 13.0 年的随访中，2044 名参与者发生 PD，77 名参与者发生 MSA，126 名参与者发生 PSP。在多变量分析中，慢性疼痛部位的数量与 PD 的发生风险之间存在剂量反应关系 （风险比，1.15;95% 置信区间，1.07-1.23）。具有 1 或 2 个疼痛部位和 3 或 4 个疼痛部位的参与者患 PD 的风险分别增加了 11% 和 49%。慢性疼痛与 MSA 或 PSP 之间没有关联。结论 慢性肌肉骨骼疼痛与 PD 独立相关，表明慢性疼痛可用于识别有患 PD 风险的个体。© 2024 年国际帕金森和运动障碍协会。