Central pain in multiple sclerosis — prevalence and clinical characteristics

Österberg, Anders; Boivie, Jörgen; Thuomas, K.-Å.

doi:10.1016/j.ejpain.2004.11.005

Cited by 316 publications

(243 citation statements)

References 35 publications

Supporting

Mentioning

216

Contrasting

Unclassified

Order By: Relevance

“…Central neuropathic pain, which is pain experienced in the absence of any psychiatric disorder or peripheral neuropathic pain, is consistent with a CNS lesion and may affect between 27.5% and 58% of MS patients. 3 In addition, as reported by Ehde et al, 4 up to 44% of people with MS experience optic neuritis pain, with 20% reporting that this type of pain significantly affects daily living. Headache pain is more common within the MS population than in the general population, affecting approximately 55% of MS patients.…”

mentioning

confidence: 76%

Interdisciplinary Treatment of Patients with Multiple Sclerosis and Chronic Pain

Sullivan

Scheman

LoPresti

et al. 2012

International Journal of MS Care

View full text Add to dashboard Cite

mentioning

confidence: 76%

Interdisciplinary Treatment of Patients with Multiple Sclerosis and Chronic Pain

Sullivan

Scheman

LoPresti

et al. 2012

International Journal of MS Care

View full text Add to dashboard Cite

“…Alternatively, exaggerated polyol pathway flux in spinal oligodendrocytes may disrupt myelination and induce cross-excitation between abnormally myelinated axons (26,27). Interestingly, a significant portion of patients with the demyelinating disease multiple sclerosis experience pain that has been hypothesized to result from spinal cord lesions (28).…”

Section: Discussionmentioning

confidence: 99%

Pathogenesis of Spinally Mediated Hyperalgesia in Diabetes

Ramos

Jiang²,

Svensson³

et al. 2007

Diabetes

View full text Add to dashboard Cite

Hyperalgesia to noxious stimuli is accompanied by increased spinal cyclooxygenase (COX)-2 protein in diabetic rats. The present studies were initiated to establish causality between increased spinal COX-2 activity and hyperalgesia during diabetes and to assess the potential involvement of polyol pathway activity in the pathogenesis of spinally mediated hyperalgesia. Rats with 1, 2, or 4 weeks of streptozotocin-induced diabetes exhibited significantly increased levels of spinal COX-2 protein and activity, along with exaggerated paw flinching in response to 0.5% paw formalin injection. Increased flinching of diabetic rats was attenuated by intrathecal pretreatment with a selective COX-2 inhibitor immediately before formalin injection, confirming the involvement of COX-2 activity in diabetic hyperalgesia. Chronic treatment with insulin or ICI222155, an aldose reductase inhibitor (ARI) previously shown to prevent spinal polyol accumulation and formalinevoked hyperalgesia in diabetic rats, prevented elevated spinal COX-2 protein and activity in diabetic rats. In contrast, the ARI IDD676 had no effect on spinal polyol accumulation, elevated spinal COX-2, or hyperalgesia to paw formalin injection. In the spinal cord, aldose reductase immunoreactivity was present solely in oligodendrocytes, which also contained COX-2 immunoreactivity. Polyol pathway flux in spinal oligodendrocytes provides a pathogenic mechanism linking hyperglycemia to hyperalgesia in diabetic rats. Diabetes 56: [1569][1570][1571][1572][1573][1574][1575][1576] 2007 A proportion of diabetic patients experience chronic pain that severely degrades their quality of life. The pathogenesis of painful diabetic neuropathy is unclear, and treatment options are currently limited to palliatives that do not target a pathogenic mechanism specific to painful diabetic neuropathy and provide limited efficacy before side effects become intolerable (1). Experimental models of diabetic neuropathy can spur development of novel therapies by providing an understanding of how diabetes alters sensory processing.Diabetic rats display abnormal pain-associated behaviors, measured as exaggerated responses to painful stimuli (hyperalgesia) or nocifensive responses to normally innocuous stimuli (allodynia). Hyperalgesia to paw formalin injection (2,3) and allodynia to tactile stimulation of the paw (4) develop within weeks of induction of hyperglycemia, and, as overt structural pathology in peripheral nerves is minimal, attention has focused on biochemical disorders that could exaggerate sensory processing.The formalin test is used to investigate spinal sensitization in animals (5) and allows investigation of sensory processing beyond peripheral nociceptive pathways. Diabetic rats exhibit increased nocifensive behavior during periods of the formalin test associated with spinal sensitization (6,7) in concert with paradoxically decreased spinal release of excitatory neurotransmitters (8,9). This suggests that hyperalgesia is not caused by increased primary afferent input and, toge...

show abstract

“…Often is extremely intense and intolerable during the night [4] with a significant impact on the quality of life (QOL) of the patients [5]. Central pain frequently develops at an interval of weeks or months after the occurrence of the lesion, does not seem to be dependent on etiology and may be the first symptom of multiple sclerosis, which may occur alone or together with other multiple sclerosis symptom-multiple sclerosis [6,7]. CP can be difficult to diagnose.…”

Section: Introductionmentioning

confidence: 99%

“…Results on prevalence studies of CP in multiple sclerosis are heterogenous, ranging from 14% to 64% among studies [4,[6][7][8][9][10][11]. The most common type of central pain in multiple sclerosis is non-paroxysmal, continuous extremity pain (dysaesthesias or ongoing pain) of the arms, legs or trunk occurring in 14-29% of multiple sclerosis patients [4,[6][7][8][9][10][11]. The common paroxysmal central pains in multiple sclerosis are trigeminal neuralgia with reported prevalence from 1.6 to 18% [5,6,[11][12][13][14] and Lhermitte´s sign with prevalence from 9 to 41% [1,11,13,15].…”

Section: Introductionmentioning

confidence: 99%

“…neuropathic pain [7]. Results on prevalence studies of CP in multiple sclerosis are heterogenous, ranging from 14% to 64% among studies [4,[6][7][8][9][10][11]. The most common type of central pain in multiple sclerosis is non-paroxysmal, continuous extremity pain (dysaesthesias or ongoing pain) of the arms, legs or trunk occurring in 14-29% of multiple sclerosis patients [4,[6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Central Pain in Patients with Multiple sclerosis

Feketova¹,

Waczulíková²,

Valkovič³

et al. 2017

J Mult Scler

View full text Add to dashboard Cite

Central pain (CP) is little recognized and diagnosed type of pain in multiple sclerosis.Objective: This second part of our work related to pain in multiple sclerosis is concentrated on occurrence of CP and defined its characteristics.Methods: Questionnaires on pain were sent to 307 patients with definitive multiple sclerosis diagnose. Patients admitting to CP were examined with aim to diagnose CP. The dates were statistically processed.Results: Out of 220 responders 92% reported pain during the course of their multiple sclerosis. CP was found in 57.72%, including 40.91% with central neuropathic extremity and trunk pain (CNEP), 5.91% with trigeminal neuralgia (TN), and 33.18% with Lhermitte's sign (LS). In 28.8% of all patients, CP was an initial multiple sclerosis symptom. The prevalence of CP does not increase with age, disease duration, or the Expanded Disability Status Scale (EDSS). Lower extremities were the commonest location of CNEP (74.5%) and burning was the commonest painful sensation. Three and more concurrent unpleasant painful sensations experienced 68.9% of patients, which were in 46.7% located in the lower extremities. Three and more concurrent CP locations (including TN and LS) were reported by 89% of patients. Number of locations in CP increases significantly with age and EDSS, in contrast to group with nociceptive and peripheral neuropathic pain (n=113), where does not increase with age, EDSS and multiple sclerosis duration. The group with nociceptive and peripheral neuropathic pain featured significantly less patients with only one pain location (p=0.0269) and only one pain quality. In contrast to the other group, In CP increases significantly the number of patients with increase the number of concurrent pain qualities (p<0.0001). Conclusion:CP is not only a frequent complaint among persons with multiple sclerosis, but is a distinctive type of pain requiring special attention and their identification remains still the major challenge.

show abstract

Central pain in multiple sclerosis — prevalence and clinical characteristics

Cited by 316 publications

References 35 publications

Interdisciplinary Treatment of Patients with Multiple Sclerosis and Chronic Pain

Interdisciplinary Treatment of Patients with Multiple Sclerosis and Chronic Pain

Pathogenesis of Spinally Mediated Hyperalgesia in Diabetes

Central Pain in Patients with Multiple sclerosis

Contact Info

Product

Resources

About