Skip to main content
Erschienen in: Journal of Neurology 4/2018

05.02.2018 | Original Communication

Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria

verfasst von: Claudio Solaro, M. Cella, Alessio Signori, Vittorio Martinelli, Marta Radaelli, D. Centonze, F. Sica, M. G. Grasso, A. Clemenzi, S. Bonavita, S. Esposito, F. Patti, E. D’Amico, G. Cruccu, A. Truini, on behalf of the Neuropathic Pain Special Interest Group of the Italian Neurological Society

Erschienen in: Journal of Neurology | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Pain is a common and heterogeneous complication of multiple sclerosis (MS). In this multicenter, cross sectional study, we aimed at investigating the prevalence of pain in MS using highly specific criteria for distinguishing the different types of pain.

Materials and methods

After a structured interview, in patients with pain, clinical examination and DN4 questionnaire were used for distinguishing neuropathic and nociceptive pain. In subjects with neuropathic pain, the Neuropathic Pain Symptom Inventory was used for differentiating neuropathic pain symptoms.

Results

We enrolled 1249 participants (832 F, 417 M, mean age 33.9 years, mean disease duration 8 years, mean EDSS 3.2); based on clinical evaluation and DN4 score 429 patients (34.34%) were classified with pain (470 pain syndromes): 286 nociceptive pain syndromes and 184 neuropathic pain syndromes. Multivariate analysis showed that pain was associated with age, gender and disease severity and that neuropathic pain was distinctly associated with EDSS.

Conclusions

Our study, providing definite information on the prevalence, characteristics and variables associated with neuropathic pain due to MS, shows that a more severe disease course is associated with a higher risk of neuropathic pain. Our findings might, therefore, provide a basis for improving the clinical management of this common MS complication.
Literatur
1.
Zurück zum Zitat Compston A, Coles A (2008) Multiple sclerosis. Lancet 25(372):1502–1517 CrossRef Compston A, Coles A (2008) Multiple sclerosis. Lancet 25(372):1502–1517 CrossRef
2.
Zurück zum Zitat Solaro C, Brichetto G, Amato MP et al (2004) The prevalence of pain in multiple sclerosis: a multicenter cross-sectional study. Neurology 63(5):919–921 CrossRefPubMed Solaro C, Brichetto G, Amato MP et al (2004) The prevalence of pain in multiple sclerosis: a multicenter cross-sectional study. Neurology 63(5):919–921 CrossRefPubMed
3.
Zurück zum Zitat O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH (2008) Pain associated with multiple sclerosis: systematic review and proposed classification. Pain 137:96–111 CrossRefPubMed O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH (2008) Pain associated with multiple sclerosis: systematic review and proposed classification. Pain 137:96–111 CrossRefPubMed
4.
Zurück zum Zitat Truini A, Galeotti F, La Cesa S et al (2012) Mechanisms of pain in multiple sclerosis: a combined clinical and neurophysiological study. Pain 153(10):2048–2054 CrossRefPubMed Truini A, Galeotti F, La Cesa S et al (2012) Mechanisms of pain in multiple sclerosis: a combined clinical and neurophysiological study. Pain 153(10):2048–2054 CrossRefPubMed
5.
Zurück zum Zitat Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S et al (2013) Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. 154(5):632–642 CrossRefPubMed Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S et al (2013) Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. 154(5):632–642 CrossRefPubMed
6.
Zurück zum Zitat Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635 CrossRefPubMed Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635 CrossRefPubMed
7.
Zurück zum Zitat Finnerup NB, Haroutounian S, Kamerman P et al (2016) Neuropathic pain: an updated grading system for research and clinical practice. Pain. 157(8):1599–1606 CrossRefPubMedPubMedCentral Finnerup NB, Haroutounian S, Kamerman P et al (2016) Neuropathic pain: an updated grading system for research and clinical practice. Pain. 157(8):1599–1606 CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L et al (2010) EFNS guidelines on neurophatic pain assessment: revised 2009. Eur J Neurol 17:1010–1018 CrossRefPubMed Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L et al (2010) EFNS guidelines on neurophatic pain assessment: revised 2009. Eur J Neurol 17:1010–1018 CrossRefPubMed
9.
Zurück zum Zitat Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al (2004) Development and validation of the Neurophatic Pain Symptom Inventorry. Pain 108:248–257 CrossRefPubMed Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al (2004) Development and validation of the Neurophatic Pain Symptom Inventorry. Pain 108:248–257 CrossRefPubMed
10.
Zurück zum Zitat Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A et al (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114:29–36 CrossRefPubMed Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A et al (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114:29–36 CrossRefPubMed
11.
Zurück zum Zitat Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C (2008) prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136:380–387 CrossRefPubMed Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C (2008) prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136:380–387 CrossRefPubMed
12.
Zurück zum Zitat Moisset X, Ouchchane L, Guy N, Bayle DJ, Dallel R, Clavelou P (2013) Migraine headaches and pain with neuropathic characteristics: comorbid conditions in patients with multiple sclerosis. Pain 154:2691–2699 CrossRefPubMed Moisset X, Ouchchane L, Guy N, Bayle DJ, Dallel R, Clavelou P (2013) Migraine headaches and pain with neuropathic characteristics: comorbid conditions in patients with multiple sclerosis. Pain 154:2691–2699 CrossRefPubMed
13.
Zurück zum Zitat Polman CH, Reingold SC, Banwell B et al (2010) Diagnostic oriteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011(69):292–302 Polman CH, Reingold SC, Banwell B et al (2010) Diagnostic oriteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011(69):292–302
14.
Zurück zum Zitat Svendsen KB, Jensen TS, Overvad K et al (2003) Pain in patients with multiple sclerosis: a population-based study. Arch Neurol 60(8):1089–1094 CrossRefPubMed Svendsen KB, Jensen TS, Overvad K et al (2003) Pain in patients with multiple sclerosis: a population-based study. Arch Neurol 60(8):1089–1094 CrossRefPubMed
15.
Zurück zum Zitat Osterberg A, Boivie J, Thuomas KA (2005) Central pain in multiple sclerosis—prevalence and clinical characteristics. Eur J Pain 9(5):531–542 CrossRefPubMed Osterberg A, Boivie J, Thuomas KA (2005) Central pain in multiple sclerosis—prevalence and clinical characteristics. Eur J Pain 9(5):531–542 CrossRefPubMed
16.
Zurück zum Zitat Svendsen KB, Sorensen L, Jensen TS, Hansen HJ, Bach FW (2011) MRI of the central nervous system in MS patients with or without pain. Eur J Pain 15(4):395–401 CrossRefPubMed Svendsen KB, Sorensen L, Jensen TS, Hansen HJ, Bach FW (2011) MRI of the central nervous system in MS patients with or without pain. Eur J Pain 15(4):395–401 CrossRefPubMed
17.
Zurück zum Zitat Hadjimichael O, Kerns RD, Rizzo MA et al (2007) Persistent pain and uncomfortable sensation in persons with multiple sclerosis. Pain 127(12):35–41 CrossRefPubMed Hadjimichael O, Kerns RD, Rizzo MA et al (2007) Persistent pain and uncomfortable sensation in persons with multiple sclerosis. Pain 127(12):35–41 CrossRefPubMed
18.
Zurück zum Zitat Tsang A, Von Korff M, Lee S et al (2008) Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression anxiety disorders. J Pain 9(10):883–891 CrossRefPubMed Tsang A, Von Korff M, Lee S et al (2008) Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression anxiety disorders. J Pain 9(10):883–891 CrossRefPubMed
19.
Zurück zum Zitat Truini A, Barbanti P, Pozzilli C et al (2013) A mechanism-based classification of pain in multiple sclerosis. J Neurol 260(2):351–367 CrossRefPubMed Truini A, Barbanti P, Pozzilli C et al (2013) A mechanism-based classification of pain in multiple sclerosis. J Neurol 260(2):351–367 CrossRefPubMed
20.
Zurück zum Zitat Brichetto G, Messmer Uccelli M, Mancardi GL, Solaro C (2003) Symptomatic medication use in multiple sclerosis. Mult Scler 9(5):458–460 CrossRefPubMed Brichetto G, Messmer Uccelli M, Mancardi GL, Solaro C (2003) Symptomatic medication use in multiple sclerosis. Mult Scler 9(5):458–460 CrossRefPubMed
21.
Zurück zum Zitat Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G (2017) Trigeminal neuralgia—diagnosis and treatment. Cephalalgia Int J Headache 37(7):648–657 CrossRef Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G (2017) Trigeminal neuralgia—diagnosis and treatment. Cephalalgia Int J Headache 37(7):648–657 CrossRef
22.
Zurück zum Zitat Solaro C, Allemani C, Messmer Uccelli M, Canevari E, Dagnino N, Pizio R, Regesta G, Tanganelli P, Battaglia MA, Mancardi GL (2005) The prevalence of multiple sclerosis in the north-west Italian province of Genoa. J Neurol 252(4):436–440 (Epub 2005 Feb 23; PubMed PMID: 15726261) CrossRefPubMed Solaro C, Allemani C, Messmer Uccelli M, Canevari E, Dagnino N, Pizio R, Regesta G, Tanganelli P, Battaglia MA, Mancardi GL (2005) The prevalence of multiple sclerosis in the north-west Italian province of Genoa. J Neurol 252(4):436–440 (Epub 2005 Feb 23; PubMed PMID: 15726261) CrossRefPubMed
Metadaten
Titel
Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria
verfasst von
Claudio Solaro
M. Cella
Alessio Signori
Vittorio Martinelli
Marta Radaelli
D. Centonze
F. Sica
M. G. Grasso
A. Clemenzi
S. Bonavita
S. Esposito
F. Patti
E. D’Amico
G. Cruccu
A. Truini
on behalf of the Neuropathic Pain Special Interest Group of the Italian Neurological Society
Publikationsdatum
05.02.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 4/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-8758-2

Weitere Artikel der Ausgabe 4/2018

Journal of Neurology 4/2018 Zur Ausgabe

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.