Jae Won Hyun1, Hyunmin Jang1, JaeBin Yu1, Na Young Park1, Su Hyun Kim1, So Young Huh2, Woojun Kim3, Min Su Park4, Jeeyoung Oh5, Kee Duk Park6, Ho Jin Kim7. 1. Department of Neurology, National Cancer Center, Goyang, Korea. 2. Department of Neurology, Kosin University College of Medicine, Busan, Korea. 3. Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea. 4. Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea. 5. Department of Neurology, Konkuk University School of Medicine, Seoul, Korea. 6. Department of Neurology, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Korea. 7. Department of Neurology, National Cancer Center, Goyang, Korea. hojinkim@ncc.re.kr.
Abstract
BACKGROUND AND PURPOSE: To compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). METHODS: From 2016 to 2018, 500 patients with NMOSD and MS from 6 referral hospitals in Korea underwent pain investigation. After the patients with current pain were matched for sex ratio and disease duration as confounding factors, PainDETECT questionnaires were assessed in 99 NMOSD and 58 MS patients to investigate neuropathic pain. The short form of the Brief Pain Inventory from 74 patients with neuropathic pain component was also analysed. RESULTS: According to the PainDETECT questionnaire, mechanical allodynia (p=0.014) and thermal hyperalgesia (p=0.011) were more severe in NMOSD patients than in MS patients. Strong involvements (score >3) of the pain in domains of tingling/prickling sensation (p=0.024), mechanical allodynia (p=0.027), sudden pain attacks (p=0.018), and thermal hyperalgesia (p=0.002) were significantly more frequent in NMOSD compared to MS patients. Among the patients experiencing pain with a neuropathic component, total pain-related interference (p=0.045) scores were significantly higher in NMOSD patients than in MS patients. In daily life, pain interfered with normal work (p=0.045) and relationships with other people (p=0.039) more often in NMOSD patients than in MS patients. Although pain medication was prescribed more frequently in NMOSD patients, the percentage of patients experiencing medication-related pain relief was lower in those patients. CONCLUSIONS: The severity of neuropathic pain and the pain-related interference in daily life were greater in NMOSD patients than in MS patients. Individualized analgesic management should be considered based on a comprehensive understanding of neuropathic pain in these patients.
BACKGROUND AND PURPOSE: To compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). METHODS: From 2016 to 2018, 500 patients with NMOSD and MS from 6 referral hospitals in Korea underwent pain investigation. After the patients with current pain were matched for sex ratio and disease duration as confounding factors, PainDETECT questionnaires were assessed in 99 NMOSD and 58 MSpatients to investigate neuropathic pain. The short form of the Brief Pain Inventory from 74 patients with neuropathic pain component was also analysed. RESULTS: According to the PainDETECT questionnaire, mechanical allodynia (p=0.014) and thermal hyperalgesia (p=0.011) were more severe in NMOSDpatients than in MSpatients. Strong involvements (score >3) of the pain in domains of tingling/prickling sensation (p=0.024), mechanical allodynia (p=0.027), sudden pain attacks (p=0.018), and thermal hyperalgesia (p=0.002) were significantly more frequent in NMOSD compared to MSpatients. Among the patients experiencing pain with a neuropathic component, total pain-related interference (p=0.045) scores were significantly higher in NMOSDpatients than in MSpatients. In daily life, pain interfered with normal work (p=0.045) and relationships with other people (p=0.039) more often in NMOSDpatients than in MSpatients. Although pain medication was prescribed more frequently in NMOSDpatients, the percentage of patients experiencing medication-related pain relief was lower in those patients. CONCLUSIONS: The severity of neuropathic pain and the pain-related interference in daily life were greater in NMOSDpatients than in MSpatients. Individualized analgesic management should be considered based on a comprehensive understanding of neuropathic pain in these patients.
Authors: Ilya Ayzenberg; Daniel Richter; Eugenia Henke; Susanna Asseyer; Friedemann Paul; Corinna Trebst; Martin W Hümmert; Joachim Havla; Tania Kümpfel; Marius Ringelstein; Orhan Aktas; Brigitte Wildemann; Sven Jarius; Vivien Häußler; Jan-Patrick Stellmann; Makbule Senel; Luisa Klotz; Hannah L Pellkofer; Martin S Weber; Marc Pawlitzki; Paulus S Rommer; Achim Berthele; Klaus-Dieter Wernecke; Kerstin Hellwig; Ralf Gold; Ingo Kleiter Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-04-20