665: Using EMA to Characterise Biopsychosocial Influences on Chronic Pain in Parkinson's Disease

Topic: Experimental (Non-clinical) Human Studies
Subtopic: Non -specific to any diagnosis, Psychology, Assessment and Measurement of Pain/Nociception, Quantitative Sensory testing (static and dynamic, e.g., HPT, PPT, CPM, TSP, offset analgesia)

Background and Aims: Parkinson's disease (PD) is the second most prevalent neurodegenerative condition worldwide, with cases anticipated to double within 30 years (Tolosa et al., 2021). Among its many non-motor symptoms, up to 85% of people with PD experience chronic pain (Viseux et al., 2023). As a multidimensional experience shaped by complex biopsychosocial influences, chronic pain remains poorly managed in this population (Marques & Brefel-Courbon, 2020; Tai & Lin, 2020). While psychosocial factors are extensively studied in the broader pain literature, equivalent research in PD is limited, and most existing work is cross-sectional.
This study investigated within-person associations between psychosocial factors and chronic pain outcomes in PD using Ecological Momentary Assessment (EMA). We hypothesised that higher pain-related worry and stigma would be associated with worse pain outcomes (greater intensity, interference, and poorer mood and sleep), whereas greater psychological flexibility and emotional support would be associated with better outcomes and lower worry and stigma.

Methods: This longitudinal observational study recruited 60 people with PD and chronic pain. At baseline, participants completed questionnaires assessing pain severity (King’s Parkinson’s Disease Pain Scale), pain interference, depression, pain-related worry, psychological flexibility, emotional support, and stigma, alongside demographic and clinical characteristics. Quantitative sensory testing (QST) was conducted to characterise somatosensory profiles.
Participants then completed EMA three times daily for 14 days, reporting real-time pain outcomes and psychosocial factors. EMA data will be analysed using linear mixed-effects models to assess associations between psychosocial factors (pain-related worry, psychological flexibility, emotional support, and stigma) and pain outcomes (pain intensity, interference, mood, and sleep). Models will estimate both within-person and between-person effects, while adjusting for relevant covariates and accommodating incomplete EMA data.

Results: Sixty participants completed baseline assessments and EMA, contributing up to 42 observations each. Mean EMA compliance was 73.5% (median: 81%), indicating good feasibility, with most participants completing over three-quarters of prompts. Analyses are underway; findings on within-person psychosocial–pain associations and between-person differences will be presented.

Conclusions: This study provides novel insight into the dynamic, real-world relationships between psychosocial factors and chronic pain in PD using EMA. Findings will improve understanding of pain fluctuations and inform the development of targeted, psychologically informed interventions.

References: Marques, A., & Brefel-Courbon, C. (2020). Chronic pain in Parkinson's disease: Clinical and pathophysiological aspects. Revue Neurologique. https://doi.org/10.1016/j.neurol.2020.06.015
Tai, Y.-C., & Lin, C.-H. (2020). An overview of pain in Parkinson's disease. Clinical Parkinsonism & Related Disorders, 2, 1–8. https://doi.org/10.1016/j.prdoa.2019.11.004
Tolosa, E., Garrido, A., Scholz, S. W., & Poewe, W. (2021). Challenges in the diagnosis of Parkinson's disease. The Lancet Neurology, 20(5), 385–397. https://doi.org/10.1016/S1474-4422(21)00030-2
Viseux, F., Delval, A., Simoneau, M., & Defebvre, L. (2023). Pain and Parkinson's disease: Current mechanism and management updates. European Journal of Pain, 27(5), 553–567. https://doi.org/10.1002/ejp.2096

Presenting Author: Zara Shafiq Rehman
Submitting Author: Zara Rehman

Senior Author: Dr Kirsty Bannister, Dr Whitney Scott

IASP 2026 Global Year theme of Neuropathic Pain: Yes