Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study
Identifieur interne : 001087 ( Istex/Corpus ); précédent : 001086; suivant : 001088Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study
Auteurs : Christine Brefel-Courbon ; Pierre Payoux ; Claire Thalamas ; Fabienne Ory ; Isabelle Quelven ; François Chollet ; Jean Louis Montastruc ; Olivier RascolSource :
- Movement Disorders [ 0885-3185 ] ; 2005-12.
English descriptors
Abstract
Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H215O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society
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DOI: 10.1002/mds.20629
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ISTEX:0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29Le document en format XML
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sortKey="Payoux, Pierre" sort="Payoux, Pierre" uniqKey="Payoux P" first="Pierre" last="Payoux">Pierre Payoux</name><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Thalamas, Claire" sort="Thalamas, Claire" uniqKey="Thalamas C" first="Claire" last="Thalamas">Claire Thalamas</name><affiliation><mods:affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Ory, Fabienne" sort="Ory, Fabienne" uniqKey="Ory F" first="Fabienne" last="Ory">Fabienne Ory</name><affiliation><mods:affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Quelven, Isabelle" sort="Quelven, Isabelle" uniqKey="Quelven I" first="Isabelle" last="Quelven">Isabelle Quelven</name><affiliation><mods:affiliation>Service de Pharmacologie 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Parkinson's disease: A clinical and positron emission tomography study</title><author><name sortKey="Brefel Ourbon, Christine" sort="Brefel Ourbon, Christine" uniqKey="Brefel Ourbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><affiliation><mods:affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Service de Pharmacologie Clinique, Faculté de Medecine, 37 Allées Jules Guesde, 31073 Toulouse Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Payoux, Pierre" sort="Payoux, Pierre" uniqKey="Payoux P" first="Pierre" last="Payoux">Pierre Payoux</name><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Thalamas, Claire" sort="Thalamas, Claire" uniqKey="Thalamas C" first="Claire" last="Thalamas">Claire Thalamas</name><affiliation><mods:affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Ory, Fabienne" sort="Ory, Fabienne" uniqKey="Ory F" first="Fabienne" last="Ory">Fabienne Ory</name><affiliation><mods:affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Quelven, Isabelle" sort="Quelven, Isabelle" uniqKey="Quelven I" first="Isabelle" last="Quelven">Isabelle Quelven</name><affiliation><mods:affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Chollet, Francois" sort="Chollet, Francois" uniqKey="Chollet F" first="François" last="Chollet">François Chollet</name><affiliation><mods:affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean Louis" last="Montastruc">Jean Louis Montastruc</name><affiliation><mods:affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><mods:affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2005-12">2005-12</date><biblScope unit="volume">20</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1557">1557</biblScope><biblScope unit="page" to="1563">1563</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29</idno><idno type="DOI">10.1002/mds.20629</idno><idno type="ArticleID">MDS20629</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>H215O positron emission tomography</term><term>Parkinson's disease</term><term>levodopa</term><term>pain threshold</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H215O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Christine Brefel‐Courbon MD</name><affiliations><json:string>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</json:string><json:string>Service de Neurologie, Purpan Hospital, Toulouse, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</json:string><json:string>Service de Pharmacologie Clinique, Faculté de Medecine, 37 Allées Jules Guesde, 31073 Toulouse Cedex, France</json:string></affiliations></json:item><json:item><name>Pierre Payoux MD</name><affiliations><json:string>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</json:string></affiliations></json:item><json:item><name>Claire Thalamas MD</name><affiliations><json:string>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</json:string></affiliations></json:item><json:item><name>Fabienne Ory MD</name><affiliations><json:string>Service de Neurologie, Purpan Hospital, Toulouse, France</json:string></affiliations></json:item><json:item><name>Isabelle Quelven PhD</name><affiliations><json:string>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</json:string></affiliations></json:item><json:item><name>François Chollet MD, PhD</name><affiliations><json:string>Service de Neurologie, Purpan Hospital, Toulouse, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</json:string></affiliations></json:item><json:item><name>Jean Louis Montastruc MD, PhD</name><affiliations><json:string>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</json:string></affiliations></json:item><json:item><name>Olivier Rascol MD, PhD</name><affiliations><json:string>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</json:string><json:string>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pain threshold</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>levodopa</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>H215O positron emission tomography</value></json:item></subject><articleId><json:string>MDS20629</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H215O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society</abstract><qualityIndicators><score>6.422</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1388</abstractCharCount><pdfWordCount>4058</pdfWordCount><pdfCharCount>26182</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>197</abstractWordCount></qualityIndicators><title>Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title><refBibs><json:item><author><json:item><name>CG Goetz</name></json:item><json:item><name>CM Tanner</name></json:item><json:item><name>M Levy</name></json:item><json:item><name>RS Wilson</name></json:item><json:item><name>DC Garron</name></json:item></author><host><volume>1</volume><pages><last>49</last><first>45</first></pages><author></author><title>Mov 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neurosurgery</json:string></scienceMetrix></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1002/mds.20629</json:string></doi><id>0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29</id><score>0.21741511</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Copyright © 2005 Movement Disorder Society</p></availability><date>2005</date></publicationStmt><notesStmt><note>Clinical Research Hospital Program from the French Ministry of Health - No. PHRC no. 0104103;</note><note>France Parkinson Association</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title><author xml:id="author-1"><persName><forename type="first">Christine</forename><surname>Brefel‐Courbon</surname></persName><roleName type="degree">MD</roleName><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><affiliation>Service de Pharmacologie Clinique, Faculté de Medecine, 37 Allées Jules Guesde, 31073 Toulouse Cedex, France</affiliation></author><author xml:id="author-2"><persName><forename type="first">Pierre</forename><surname>Payoux</surname></persName><roleName type="degree">MD</roleName><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation></author><author xml:id="author-3"><persName><forename type="first">Claire</forename><surname>Thalamas</surname></persName><roleName type="degree">MD</roleName><affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</affiliation></author><author xml:id="author-4"><persName><forename type="first">Fabienne</forename><surname>Ory</surname></persName><roleName type="degree">MD</roleName><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation></author><author xml:id="author-5"><persName><forename type="first">Isabelle</forename><surname>Quelven</surname></persName><roleName type="degree">PhD</roleName><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation></author><author xml:id="author-6"><persName><forename type="first">François</forename><surname>Chollet</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation></author><author xml:id="author-7"><persName><forename type="first">Jean Louis</forename><surname>Montastruc</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation></author><author xml:id="author-8"><persName><forename type="first">Olivier</forename><surname>Rascol</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2005-12"></date><biblScope unit="volume">20</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1557">1557</biblScope><biblScope unit="page" to="1563">1563</biblScope></imprint></monogr><idno type="istex">0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29</idno><idno type="DOI">10.1002/mds.20629</idno><idno type="ArticleID">MDS20629</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H215O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>Parkinson's disease</term></item><item><term>pain threshold</term></item><item><term>levodopa</term></item><item><term>H215O positron emission tomography</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-11-12">Received</change><change when="2005-03-08">Registration</change><change when="2005-12">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/0EA5DE53F8CADB17F74C9BC2F0A161EAF1810D29/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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href="file:MDS.MDS20629.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="33"></count><count type="wordTotal" number="4830"></count></countGroup><titleGroup><title type="main" xml:lang="en">Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title><title type="short" xml:lang="en">Levodopa Effect <fi>on</fi> Pain Threshold in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2 #af3" corresponding="yes"><personName><givenNames>Christine</givenNames><familyName>Brefel‐Courbon</familyName><degrees>MD</degrees></personName><contactDetails><email>brefel@cict.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Pierre</givenNames><familyName>Payoux</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Claire</givenNames><familyName>Thalamas</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Fabienne</givenNames><familyName>Ory</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Isabelle</givenNames><familyName>Quelven</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>François</givenNames><familyName>Chollet</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jean Louis</givenNames><familyName>Montastruc</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af3 #af4"><personName><givenNames>Olivier</givenNames><familyName>Rascol</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="FR" type="organization"><unparsedAffiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">pain threshold</keyword><keyword xml:id="kwd3">levodopa</keyword><keyword xml:id="kwd4">H<sub>2</sub><sup>15</sup>O positron emission tomography</keyword></keywordGroup><fundingInfo><fundingAgency>Clinical Research Hospital Program from the French Ministry of Health</fundingAgency><fundingNumber>PHRC no. 0104103</fundingNumber></fundingInfo><fundingInfo><fundingAgency>France Parkinson Association</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: <i>off</i> and <i>on</i>. We performed H<sub>2</sub><sup>15</sup>O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during <i>off</i> and <i>on</i> conditions. In <i>off</i> condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During <i>off</i> condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Levodopa Effect on Pain Threshold in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study</title></titleInfo><name type="personal"><namePart type="given">Christine</namePart><namePart type="family">Brefel‐Courbon</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><affiliation>Service de Pharmacologie Clinique, Faculté de Medecine, 37 Allées Jules Guesde, 31073 Toulouse Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Payoux</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claire</namePart><namePart type="family">Thalamas</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fabienne</namePart><namePart type="family">Ory</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Isabelle</namePart><namePart type="family">Quelven</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">François</namePart><namePart type="family">Chollet</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Service de Neurologie, Purpan Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean Louis</namePart><namePart type="family">Montastruc</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Olivier</namePart><namePart type="family">Rascol</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Service de Pharmacologie Clinique, University Hospital, Toulouse, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale U455, Toulouse, France</affiliation><affiliation>Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2005-12</dateIssued><dateCaptured encoding="w3cdtf">2004-11-12</dateCaptured><dateValid encoding="w3cdtf">2005-03-08</dateValid><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">4</extent><extent unit="references">33</extent><extent unit="words">4830</extent></physicalDescription><abstract lang="en">Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H215O PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain‐induced activation in right insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain‐induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain‐induced activation in nociceptive pathways, which can be reduced by levodopa. © 2005 Movement Disorder Society</abstract><note type="funding">Clinical Research Hospital Program from the French Ministry of Health - No. PHRC no. 0104103; </note><note type="funding">France Parkinson Association</note><subject lang="en"><genre>keywords</genre><topic>Parkinson's disease</topic><topic>pain threshold</topic><topic>levodopa</topic><topic>H215O positron emission tomography</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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