Increased multiple sclerosis relapses related to lower prevalence of pain

Silva, José Vinícius Martins da; Oliveira, Beatriz Fátima Alves de; Nascimento, Osvaldo J. M.; Farinhas, João Gabriel Dib; Cavaliere, Maria Graziella; Cal, Henrique; Matta, André Palma da Cunha

doi:10.1590/0004-282x20150073

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…In this study, we had the exceptional opportunity of observing NP whether it was induced by the use of all MS therapies in a relatively large group. As consistent with data from previous studies, we also have not seen a relationship between NP and DMTs [26,27,30].…”

Section: Discussionsupporting

confidence: 93%

“…In contrast, Doolen et al reported that ngolimod might reduce NP in a mouse model by reversing central sensitization in the dorsal column of the spinal cord [29]. Also, glatiramer acetate was found effective in preventing long-term allodynia and hyperalgesia by reducing the expression of the chemotactic fractalkine chemokine in the dorsal horn [30]. In this study, we had the exceptional opportunity of observing NP whether it was induced by the use of all MS therapies in a relatively large group.…”

Section: Discussionmentioning

confidence: 85%

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Neuropathic Extremity Pain in Patients With Multiple Sclerosis: Preventive and Personalized Approach

Uzunköprü

Yılmaz

Beckmann

2021

Preprint

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BackgroundNeuropathic extremity pain is a disabling symptom in patients with multiple sclerosis. The aim of this study is to evaluate the prevalence of neuropathic extremity pain among patients with multiple sclerosis and to assess its effect on quality of life.MethodsThe present cross-sectional study included 180 patients with relapsing-remitting multiple sclerosis. Douleur Neuropathique 4 pain scale and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were used to evaluate neuropathic pain. The effect of neuropathic extremity pain on quality of life was assessed by the 36-Item Short Form Survey. ResultsThe mean age and the mean disease duration were 38.78±9.37 and 8.96±6.93 years, respectively. The prevalence of neuropathic extremity pain was 38.9% in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and 47.8% in the Douleur Neuropathique 4 pain scale. The presence of neuropathic extremity pain was associated with the higher Expanded Disability Status Scale in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale (p=0.015) and the longer disease duration in the Douleur Neuropathique 4 pain scale (p=0.021). All patients with psychiatric disorders reported neuropathic extremity pain. Lower 36-Item Short Form Survey scores were obtained in patients with neuropathic extremity pain than patients without neuropathic extremity pain in all domains of 36-Item Short Form Survey.ConclusionsThis study suggests that neuropathic extremity pain is a common symptom among patients with multiple sclerosis. Higher disability and longer disease duration are associated with neuropathic extremity pain. The presence of pain and psychiatric disorders are related to the impairment of the quality of life.Relevance of the article for predictive, preventive, and personalized medicine Questioning of pain is often neglected in multiple sclerosis practice. However, identification and treatment of pain has the potential to increase the quality of life in patients with multiple sclerosis. This article emphasizes that revealing the presence of pain might improve clinical outcome in multiple sclerosis patients providing personalized approaches to disease course.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 85%

Neuropathic Extremity Pain in Patients With Multiple Sclerosis: Preventive and Personalized Approach

Uzunköprü

Yılmaz

Beckmann

2021

Preprint

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“…Most studies report associations between the likelihood of experiencing pain and pain intensity with longer disease duration, more progressive forms of MS and level of disability ( 14 , 23 , 24 ), while some do not ( 3 , 25 , 26 ). Inconsistent findings of associations between pain and relapses have also been reported, with some showing associations of pain with higher relapse rate ( 23 ), while others report increased relapses associated with lower prevalence of pain ( 26 ). In univariable analyses, we found a reduced risk of pain in people with relapsing remitting MS (RRMS), older age and female gender, in line with others ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life

et al. 2017

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BackgroundPeople with multiple sclerosis (MS) often experience pain, which can interfere with mobility, employment, and quality of life (QOL).MethodsThis cross-sectional study explored associations between pain, demographic, disease, and modifiable lifestyle factors in an international sample of people with MS recruited online.ResultsSubstantial pain, of moderate/severe intensity and interfering at least moderately with work/household or enjoyment of life in the past 4 weeks, was reported by 682/2,362 (28.9%). Substantial pain was associated with fatigue (odds ratio (OR): 6.7, 95% confidence interval (CI): 4.9,9.3), depression (OR:4.0, 95% CI:3.2,5.1), anxiety (OR:2.4, 95% CI:1.9,2.9), and lower mental health QOL (Mean Difference: −14.7, 95% CI:−16.6,−12.8). Regression analyses showed that smoking (OR: 2.0, 95% CI:1.35,2.87) and obesity (OR:2.1, 95% CI: 1.5,2.8), moderate alcohol use (OR: 0.7, 95% CI:0.5,0.9), moderate (OR 0.7, 95% CI: 0.55,0.98) or high (OR 0.6, 95% CI: 0.4,0.8) physical activity level, and healthy diet (OR 0.8, 95% CI: 0.75,0.95, per 10 points) were associated with substantial pain.ConclusionOur results show clear associations with modifiable lifestyle factors and substantial pain in MS. These factors are already considered in the prevention and management of pain in other populations but have not previously been considered in MS. Conversely, pain and associated common MS comorbidities, such as depression, anxiety, and fatigue, may hamper efforts to start or maintain healthy behaviors. Strategies to overcome these barriers need to be considered. Further research should clarify the direction of these associations.

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