Longitudinal prevalence and determinants of pain in multiple sclerosis: results from the German National Multiple Sclerosis Cohort study

被引：27

作者：

Heitmann, Henrik ^{[1
]}

Haller, Bernhard ^{[2
]}

Tiemann, Laura ^{[1
]}

Muehlau, Mark ^{[1
]}

Berthele, Achim ^{[1
]}

Toelle, Thomas R. ^{[1
]}

Salmen, Anke ^{[3
,4
]}

Ambrosius, Bjoern ^{[3
]}

Bayas, Antonios ^{[5
]}

Asseyer, Susanna ^{[6
]}

Hartung, Hans-Peter ^{[7
]}

Heesen, Christoph ^{[8
]}

Stangel, Martin ^{[9
]}

Wildemann, Brigitte ^{[10
]}

Haars, Sarah ^{[11
]}

Groppa, Sergiu ^{[12
,13
]}

Luessi, Felix ^{[12
,13
]}

Kuempfel, Tania ^{[14
]}

Nischwitz, Sandra ^{[15
]}

Meuth, Sven G. ^{[16
]}

Klotz, Luisa ^{[16
]}

Linker, Ralf A. ^{[17
]}

Zettl, Uwe K. ^{[18
]}

Ziemann, Ulf ^{[19
]}

Tumani, Hayrettin ^{[20
,21
]}

Tackenberg, Bjoern ^{[22
]}

Zipp, Frauke ^{[12
,13
]}

Wiendl, Heinz ^{[16
]}

Gold, Ralf ^{[3
]}

Hemmer, Bernhard ^{[1
,23
]}

Ploner, Markus ^{[1
]}

机构：

[1] Tech Univ Munich, Sch Med, Dept Neurol, D-81675 Munich, Germany

[2] TUM, Inst Med Informat Stat & Epidemiol, Sch Med, Munich, Germany

[3] Ruhr Univ Bochum, St Josef Hosp, Dept Neurol, Bochum, Germany

[4] Univ Bern, Bern Univ Hosp, Dept Neurol, Inselspital, Bern, Switzerland

[5] Univ Hosp Augsburg, Dept Neurol, Augsburg, Germany

[6] Charite Univ Med Berlin, NeuroCure Clin Res Ctr, Expt & Clin Res Ctr, Ctr Mol Med, Berlin, Germany

[7] Heinrich Heine Univ, Dept Neurol, Dusseldorf, Germany

[8] Univ Klinikum Hamburg Eppendorf, Inst Neuroimmunol & Multiple Sclerosis, Hamburg, Germany

[9] Hannover Med Sch, Dept Neurol, Clin Neuroimmunol & Neurochem, Hannover, Germany

[10] Heidelberg Univ, Dept Neurol, Heidelberg, Germany

[11] Univ Leipzig, Dept Neurol, Leipzig, Germany

[12] Johannes Gutenberg Univ Mainz, Dept Neurol, Rhine Main Neurosci Network Rmn2, Univ Med Ctr, Mainz, Germany

[13] Johannes Gutenberg Univ Mainz, Focus Program Translat Neurosci FTN, Rhine Main Neurosci Network Rmn2, Univ Med Ctr, Mainz, Germany

[14] Ludwig Maximilian Univ Munich, Inst Clin Neuroimmunol, Munich, Germany

[15] Max Planck Inst Psychiat, Neurol, Munich, Germany

[16] Westfalische Wilhelms Univ Munster, Univ Hosp Munster, Dept Neurol, Munster, Germany

[17] Univ Regensburg, Medbo Hosp Neurol, Dept Neurol, Regensburg, Germany

[18] Univ Rostock, Dept Neurol, Rostock, Germany

[19] Eberhard Karls Univ Tubingen, Hertie Inst Clin Brain Res, Dept Neurol & Stroke, Tubingen, Germany

[20] Univ Ulm, Dept Neurol, Ulm, Germany

[21] Clin Neurol Dietenbronn, Schwendi, Germany

[22] Philipps Univ Marburg, Dept Neurol, Marburg, Germany

[23] Munich Cluster Syst Neurol SyNergy, Munich, Germany

来源：

PAIN | 2020年 / 161卷 / 04期

关键词：

Multiple sclerosis; Neuropathic pain; Epidemiology; Depression; Fatigue; QUALITY-OF-LIFE; NEUROPATHIC PAIN; MISSING DATA; FOLLOW-UP; FATIGUE; DEPRESSION; IMPAIRMENT; SCALE;

D O I：

10.1097/j.pain.0000000000001767

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Pain is frequent in multiple sclerosis (MS) and includes different types, with neuropathic pain (NP) being most closely related to MS pathology. However, prevalence estimates vary largely, and causal relationships between pain and biopsychosocial factors in MS are largely unknown. Longitudinal studies might help to clarify the prevalence and determinants of pain in MS. To this end, we analyzed data from 410 patients with newly diagnosed clinically isolated syndrome or relapsing-remitting MS participating in the prospective multicenter German National MS Cohort Study (NationMS) at baseline and after 4 years. Pain was assessed by self-report using the PainDETECT Questionnaire. Neuropsychiatric assessment included tests for fatigue, depression, and cognition. In addition, sociodemographic and clinical data were obtained. Prevalence of pain of any type was 40% and 36% at baseline and after 4 years, respectively, whereas prevalence of NP was 2% and 5%. Pain of any type and NP were both strongly linked to fatigue, depression, and disability. This link was even stronger after 4 years than at baseline. Moreover, changes in pain, depression, and fatigue were highly correlated without any of these symptoms preceding the others. Taken together, pain of any type seems to be much more frequent than NP in early nonprogressive MS. Moreover, the close relationship between pain, fatigue, and depression in MS should be considered for treatment decisions and future research on a possible common pathophysiology.

引用

页码：787 / 796

页数：10

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