BACKGROUND: Central pain (CP) is a common symptom in MS. Multiple theories are present about the mechanism of CP. Previous studies suggested that lesion of the spinothalamic tract is a necessary condition for development of CP. No previous study has in detail evaluated the association between the specific site of demyelinations and the presence of CP in MS. OBJECTIVE: The study aimed to evaluate the location of plaques in MS patients with CP including a group of MS patients without pain as a reference group. METHODS: All patients underwent a bedside sensory examination and MRI of the brain and spinal cord. MR imaging was acquired on an 1.5 Tesla MR equipment. A trained neuroradiologist, blinded to pain status, evaluated the MRI. RESULTS: Thirteen MS patients with CP and 10 MS patients without pain were included. Allodynia and/or dysesthesia were more frequent in pain patients (11/13 vs. 1/10, P<0.01). No difference was found in the number of patients with plaques in spinothalamic tract, dorsal column-medial lemniscus, dorsolateral funiculus, grey substance, thalamus or capsula interna. A non-significantly lower number of pain patients had lesions in thalamo-cortical pathways (8/13 vs. 10/10, P=0.027). CONCLUSIONS: No association between CP and site of demyelinations was found, although a trend toward a higher prevalence of intact thalamo-cortical pathways was seen in pain patients. CP was associated with allodynia, suggesting central hyperexcitability.
BACKGROUND: Central pain (CP) is a common symptom in MS. Multiple theories are present about the mechanism of CP. Previous studies suggested that lesion of the spinothalamic tract is a necessary condition for development of CP. No previous study has in detail evaluated the association between the specific site of demyelinations and the presence of CP in MS. OBJECTIVE: The study aimed to evaluate the location of plaques in MSpatients with CP including a group of MSpatients without pain as a reference group. METHODS: All patients underwent a bedside sensory examination and MRI of the brain and spinal cord. MR imaging was acquired on an 1.5 Tesla MR equipment. A trained neuroradiologist, blinded to pain status, evaluated the MRI. RESULTS: Thirteen MSpatients with CP and 10 MSpatients without pain were included. Allodynia and/or dysesthesia were more frequent in painpatients (11/13 vs. 1/10, P<0.01). No difference was found in the number of patients with plaques in spinothalamic tract, dorsal column-medial lemniscus, dorsolateral funiculus, grey substance, thalamus or capsula interna. A non-significantly lower number of painpatients had lesions in thalamo-cortical pathways (8/13 vs. 10/10, P=0.027). CONCLUSIONS: No association between CP and site of demyelinations was found, although a trend toward a higher prevalence of intact thalamo-cortical pathways was seen in painpatients. CP was associated with allodynia, suggesting central hyperexcitability.
Authors: 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 Journal: J Neurol Date: 2018-02-05 Impact factor: 4.849
Authors: Darin T Okuda; Kara Melmed; Takashi Matsuwaki; Anders Blomqvist; Arthur D Bud Craig Journal: Ann Clin Transl Neurol Date: 2014-07-28 Impact factor: 4.511
Authors: Rogier J Scherder; Neeltje Kant; Evelien T Wolf; Bas C M Pijnenburg; Erik J A Scherder Journal: Pain Res Manag Date: 2018-04-23 Impact factor: 3.037