Chronic Pain And Levodopa Therapy in Parkinson’s Disease Patients

Carlos Henrique Ferreira Camargo1, *, Marcelo Rezende Young Blood2, Camila Medyk2, Matheus Gomes Ferreira3, Marcelo Machado Ferro4, Hélio Afonso Ghizoni Teive1, 3
1 Neurodegenerative Disorders Group, Postgraduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
2 Department of Neurology, Hospital Universitário Regional dos Campos Gerais, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
3 Department of Internal Medicine, Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
4 Neuropsychopharmacology Laboratory, State University of Ponta Grossa, Ponta Grossa, PR, Brazil

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© 2022 Camargo et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Hospital de Clínicas, Programa de Pós-Graduação em Medicina Interna – 11º Andar, Rua General Carneiro, 181, 80060-000, Curitiba, PR, Brazil; E-mail:



Pain is a frequent non-motor symptom in patients with Parkinson’s disease (PD) and appears to be related to low levels of dopamine. This study describes the characteristics of chronic pain in a group of PD patients undergoing levodopa therapy.


This was a cross-sectional study. The pain was assessed in 21 selected PD patients with chronic pain using several scales and instruments. Changes in pain response from levodopa use (wearing-off phenomenon) were monitored.


The most prevalent type of pain was nociceptive (71.4%), musculoskeletal and dystonic, but neuropathic pain accounted for the highest pain score according to the Parkinson’s Disease Pain Classification System (45.5±30.08). Patients with neuropathic, nociplastic, or nociceptive pain upon wearing-off were those who responded to levodopa (p=0.999). According to the McGill questionnaire, patients with pain upon wearing-off had higher scores in the affective/motivational dimension (p=0.022).


Using a new pain classification and scoring tool, this study corroborates a good response to levodopa in PD-related pain.

Keywords: Parkinson’s disease, Pain, Antiparkinson agents, Levodopa, Pain Classification, Parkinsonism.