IMR Press / JIN / Volume 20 / Issue 4 / DOI: 10.31083/j.jin2004108
Open Access Review
Pain in neurodegenerative diseases with atypical parkinsonism: a systematic review on prevalence, clinical presentation, and findings from experimental studies
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1 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience at King’s College London, SE5 9RT London, UK
2 Parkinson’s Foundation Centre of Excellence, King’s College Hospital, SE5 9RS London, UK
3 Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King’s College London, SE5 9RT London, UK
4 NIHR Mental Health Biomedical Research Centre and Dementia Biomedical Research Unit, South London and Maudsley NHS Foundation Trust and King’s College London, SE5 9RS London, UK
*Correspondence: (K Ray Chaudhuri)
These authors contributed equally.
J. Integr. Neurosci. 2021, 20(4), 1067–1078;
Submitted: 27 June 2021 | Revised: 25 September 2021 | Accepted: 10 November 2021 | Published: 30 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (

Parkinson’s disease-related pain has increasingly been investigated in research studies. Still, only a few studies have addressed the prevalence and clinical characteristics of pain in neurodegenerative disorders with atypical parkinsonism. The existing evidence, although scarce, suggests that, similarly as in Parkinson’s disease, individuals with neurodegenerative diseases with atypical parkinsonism might be predisposed to the development of persistent pain. Today, as the global population is aging and we face an epidemic of neurodegenerative disorders, under-treated pain is taking a great toll on an ever-rising number of people. Here, we provide an up-to-date review of the current knowledge on the prevalence of pain, its clinical features, and findings from experimental studies that might signpost altered pain processing in the most prevalent neurodegenerative disorders with atypical parkinsonism: multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome, frontotemporal dementia, and dementia with Lewy bodies. Finally, we point out the current gaps and unmet needs that future research studies should focus on. Large-scale, high-quality clinical trials, coupled with pre-clinical research, are urgently needed to reveal the exact pathophysiological mechanisms underpinning heightened pain and pave the path for mechanistically-driven analgesic interventions to be developed, ultimately leading to an improvement in the quality of life of individuals with neurodegenerative disorders.

Atypical parkinsonism
Multiple system atrophy
Progressive supranuclear palsy
Cortico-basal syndrome
Frontotemporal dementia
Dementia with Lewy bodies
Fig. 1.
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