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Comment & Response
September 2015

Considerations of Long-term Pain Evaluation Post– Deep Brain Stimulation Surgery—Reply

Author Affiliations
  • 1Department of Neurology, College of Medicine, Kyung Hee University, Seoul, South Korea
  • 2Department of Neurology and Movement Disorder Center, Parkinson Study Group, Seoul National University Hospital, Seoul, South Korea
JAMA Neurol. 2015;72(9):1077-1078. doi:10.1001/jamaneurol.2015.1590

In Reply We thank Xiao et al for their interest in our article1 and giving us the opportunity to highlight our results.

In our study, new pain was defined as any pain at follow-up that was not present at baseline. We included any type of pain that patients reported, irrespective of its presumptive cause, which is more relevant to clinical situations than excluding pains that may have causes other than Parkinson disease (PD). Therefore, we did not mean that new pain was directly associated with PD or subthalamic nucleus deep brain stimulation (STN DBS) surgery. We agree with Xiao et al that pain in patients with PD can arise in association with many conditions other than PD and proper evaluation of these factors is rarely carried out. We believe that at least some of the new pain was actually caused by the comorbidities that the patient already had at baseline. Even in this case, we labeled it as new pain because that pain was not discussed or disturbing before surgery. It may be that other severe motor and functional disabilities overshadowed that pain preoperatively and that “when the tiger’s away, the fox will play.”

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