Peripheral neuropathy is a common problem in patients with Parkinson’s disease. Peripheral neuropathy’s prevalence in Parkinson’s disease varies between 4.8–55%, compared with 9% in the general population. It remains unclear whether peripheral neuropathy leads to decreased motor performance in Parkinson’s disease, resulting in impaired mobility and increased balance deficits. We aimed to determine the prevalence and type of peripheral neuropathy in Parkinson’s disease patients and evaluate its functional impact on gait and balance.
A cohort of consecutive Parkinson’s disease patients assessed by movement disorders specialists based on the UK Brain Bank criteria underwent clinical, neurophysiological (nerve conduction studies and quantitative sensory testing) and neuropathological (intraepidermal nerve fibre density in skin biopsy punches) evaluation to characterize the peripheral neuropathy type and aetiology using a cross-sectional design. Gait and balance were characterized using wearable health-technology in OFF and ON medication states, and the main parameters were extracted using validated algorithms.
A total of 99 Parkinson’s disease participants with a mean age of 67.2 (±10) years and mean disease duration of 6.5 (±5) years were assessed. Based on a comprehensive clinical, neurophysiological and neuropathological evaluation, we found that 40.4% of Parkinson’s disease patients presented peripheral neuropathy, with a predominance of small fibre neuropathy (70% of the group). In the OFF state, the presence of peripheral neuropathy was significantly associated with shorter stride length (P = 0.029), slower gait speed (P = 0.005) and smaller toe-off angles (P = 0.002) during straight walking; significantly slower speed (P = 0.019) and smaller toe-off angles (P = 0.007) were also observed during circular walking. In the ON state, the above effects remained, albeit moderately reduced. With regard to balance, significant differences between Parkinson’s disease patients with and without peripheral neuropathy were observed in the OFF medication state during stance with closed eyes on a foam surface. In the ON states, these differences were no longer observable.
We showed that peripheral neuropathy is common in Parkinson’s disease and influences gait and balance parameters, as measured with mobile health-technology. Our study supports that peripheral neuropathy recognition and directed treatment should be pursued in order to improve gait in Parkinson’s disease patients and minimize balance-related disability, targeting individualized medical care.
Good evening everyone. As I have mentioned before I have Atypical Parkinson’s disease. I have had a positive DATscan & a Neurologist’s diagnosis.
I saw my Neurologist today & was told I also had Peripheral Neuropathy & I am going to Brighton for tests in 4-6 weeks.
I was also told to stop all my Parkinson’s medication as it is not doing me any good & may cause other problems.
Reading the article above I was amazed how many Parkinson’s people have Peripheral Neuropathy. Also which do you get first & are they linked. How can they tell which symptoms relate to which disease?
I am 63yo and I was diagnosed with PD 10 years ago, PAD two years ago. I did not realise that there was a correlation between them. None of my medical team have mentioned a link.
Interested in hearing other people’s comments.
Hello Geoffrey … I forgot to say that the Neurologist prescribed amitriptyline for the Peripheral Neuropathy. Do you take anything for your PAD ?
Hello again Geoffrey I got beaten by a 91 year old today 18-2 at indoor bowls. Do you think the medication will help me?
Well, that depends on weather you are younger or older than your opponent.
He is old enough to be my Dad [just about]. I’m 69
Did they exclude in the researchfor other causes of peripheral neuropathy such as diabetes?
Hello Douglas … Strangely I had just had a blood test at my GP’s a few days before. The Neurologist had my blood test results on the computer. No Diabetes. I am fairly slim & I do eat sensibly, don’t drink or smoke & have been incredibly fit till these current issues kicked in. Cholesterol 5.1 [should be 5] being the only slight issue.
I did have aggressive Prostate Cancer aged 59 & had the prostate removed, which set me back. This last decade has been
a lot of fun [sarcasm].
Hello again Douglas … My dream is to actually have something that can be treated so that I can get physically better. If it were merely Atypical Parkinson’s causing all my symptoms then I am screwed. The Neurologist said that no medication is going to help my Parkinson’s condition. I am booked to see him again early December & my Parkinson’s nurse [sadly a bloke with a beard & tattoos], [Good at his job though] in November.
Hi Steve. I hope that your prostate removal got your cancer before it was able to metastasise. I feel for you having to deal with the cancer and now atypical PD - and all that comes with them both. Get in touch by DM if you need to talk.
Am intrested in your medical history which has some similarity to my own. I have had PD for aprox 10 years, About 12 months ago I started to suffer from pain in my feet which I now understand was Peripheral Neuropathy.
The pain only occurred when I was laying in bed and my feet were bearing the weight of the bed clothes. If I moved my feet around, the pain vanished, Of more interest- I have recently been experimenting with different beds and the neuropathy has completely gone - at least the pain has. I have now been diagnosed with Prostate cancer with a recent PSA of 93. I am currently awaiting the report of a bone scan to determine if the cancer has metastasised.
I see there has been a lot of conversation on this topic so I thought it would be helpful to add our input to summaries this recent study so it is more accessible for other members on the forum.
Peripheral neuropathy is a common problem seen in people with Parkinson’s. It occurs when nerves in the body are damaged and often affects the hands, feet, legs and arms. It can cause a numbness or tingling feeling, muscle weakness and shooting pains in the affected areas.
The study referred to in this post can be found here. Researchers assessed 99 people with Parkinson’s and reported that just over 40% showed signs of peripheral neuropathy. The researchers also found that peripheral neuropathy made balance and movement problems worse in people with Parkinson’s, including a smaller gait and slower movements.
The results showed that peripheral neuropathy is common in people with Parkinson’s and can have an impact on both balance and movements, such as walking. It suggests that peripheral neuropathy should be considered in people with Parkinson’s who struggle with balance and movement, and that treatment for peripheral neuropathy alongside normal Parkinson’s medication may ease these symptoms.
Further research is needed to determine whether peripheral neuropathy and Parkinson’s are directly related, or whether they progress independently of each other.
We recommend that if this raises any concerns or queries, you seek advice from your health care team, who will be able to support you accordingly.
I hope this information is helpful.
Did the study exclude people living with diabetes? Peripheral Neuropathy is one of the complications of diabetes.