Parkinson Hastalýðýnda Aðrý ve D Vitamini Ýliþkisi

GÝRÝÞ ve AMAÇ: Parkinson hastalarýnda en sýk görülen nonmotor semptomlardan biri aðrýdýr ve bazen dirençli aðrý yakýnmasý yaþam kalitesini olumsuz
etkilemektedir. Özellikle kas iskelet sistemi ile ilgili aðrýlar olmak üzere pek çok aðrý tipi ile D vitamini arasýnda iliþki olduðu farklý çalýþmalarda vurgulanmýþtýr.
YÖNTEM ve GEREÇLER: Hoehn-Yahr skalasýna göre evre 3’ün üstünde olan, mini mental durum testi (MMSE) 25 ve üstünde olup demans tanýsý olmayan, D vitamini düzeyini etkileyecek hastalýðý ve ilaç kullanýmý olmayan 43 idiyopatik Parkinson hastasýnýn demografik verileri, Bileþik Parkinson Hastalýðý Deðerlendirme Ölçeði (BPHDÖ) (UPDRS) motor alt skalasý, nonmotor semptom skalasý ve kýsaltýlmýþ geriyatrik depresyon ölçeði (GDÖ) kaydedilerek D vitamini düzeyi ile aðrý yakýnmasý arasýndaki iliþki deðerlendirilmiþtir.
BULGULAR: Çalýþmaya katýlan hastalarýn 24’ü erkek 19’u kadýndýr. Hastalarýn yaþ ortalamasý 61.9 (±9.84) olarak belirlenmiþtir. Ortalama hastalýk süresi 3.9 yýl; UPDRS motor skor ortalamasý 18.3 (±7.6) bulunmuþtur. Nonmotor semptom skalasýna göre yapýlan deðerlendirmede hastalar 30 üzerinden 10.2 (±5.3) puan almýþlardýr. Hastalarýn %60.5’inde aðrý yakýnmasý olduðu görülmüþtür. Aðrý varlýðý ile D vitamini düzeyi, yaþ, hastalýk süresi, UPDRS, ilaç dozu, nonmotor semptom skoru, GDÖ, arasýnda anlamlý iliþki (p>0.05) bulunamamýþtýr. Ýlaç dozu açýsýndan 60 yaþ ve altýndaki hasta grubunda aðrýsý olan ve olmayan hastalarýn levodopa dozlarý arasýnda anlamlý fark bulunmuþtur (p=0.04). Aðrýsý olanlarýn levodopa dozlarý olmayanlara göre yüksek bulunmuþtur. Altmýþ yaþ üstündeki hastalarda aðrý varlýðý ile UPDRS arasýnda anlamlý pozitif iliþki bulunmuþtur (p=0.035).
TARTIÞMA ve SONUÇ: Çalýþmanýn sonucunda aðrý ile D vitamini düzeyleri arasýnda iliþki tespit edilmedi. Daha büyük hasta gruplarýnda aðrý alt tiplerini belirleyerek aðrý ile D vitamini düzeyleri arasýndaki iliþkinin incelenmesinin önemli olduðu düþünülmüþtür.

The Relationship Between Pain and Vitamin D in Parkinson's Disease

INTRODUCTION: Pain is one of the most common nonmotor symptoms in patients with Parkinson's disease, and sometimes the complaint of refractory pain adversely affects quality of life. The relationship between vitamin D and many types of pain, especially musculoskeletal pain, has been emphasized in different studies.
METHODS: The demographic data of 43 idiopathic Parkinson's patients who are above stage 3 according to the Hoehn and Yahr scale, with MMSE 25 and above, and who had not received a diagnosis of dementia, and who had no disease and drug use affecting the vitamin D level, the UPDRS motor subscale, the nonmotor symptom scale and the shortened geriatric depression scale, were recorded. The relationship between vitamin D level and pain was evaluated.
RESULTS: Of the patients included in the study, 24 were male and 19 were female. The mean age of the patients was 61.9 (± 9.84) years. The mean disease duration was 3.9 years; the mean UPDRS motor score was 18.3 (± 7.6). According to the nonmotor symptom scale, the patients scored 10.2 (± 5.3) out of 30. 60.5% of the patients had pain complaints. No significant relationship was found between pain and vitamin D level, age, disease duration, UPDRS, drug dose, nonmotor symptom score, GDS, (p>0.05). A significant difference was found between levodopa doses of patients with and without pain in the 60-year-old and younger patients (p = 0.04). Levodopa doses of patients with pain were higher than those without pain. A significant positive correlation was found between the presence of pain and UPDRS in patients over 60 years (p = 0.035).
DISCUSSION AND CONCLUSION: As a result of the study, no relation was found between pain and vitamin D levels. In larger patient populations, it was thought to be important to examine the relationship between pain and Vitamin D levels by identifying pain subtypes.