Skip to main content
Top
Published in: Journal of Neurology 4/2018

01-04-2018 | Original Communication

Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria

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, on behalf of the Neuropathic Pain Special Interest Group of the Italian Neurological Society

Published in: Journal of Neurology | Issue 4/2018

Login to get access

Abstract

Background

Pain is a common and heterogeneous complication of multiple sclerosis (MS). In this multicenter, cross sectional study, we aimed at investigating the prevalence of pain in MS using highly specific criteria for distinguishing the different types of pain.

Materials and methods

After a structured interview, in patients with pain, clinical examination and DN4 questionnaire were used for distinguishing neuropathic and nociceptive pain. In subjects with neuropathic pain, the Neuropathic Pain Symptom Inventory was used for differentiating neuropathic pain symptoms.

Results

We enrolled 1249 participants (832 F, 417 M, mean age 33.9 years, mean disease duration 8 years, mean EDSS 3.2); based on clinical evaluation and DN4 score 429 patients (34.34%) were classified with pain (470 pain syndromes): 286 nociceptive pain syndromes and 184 neuropathic pain syndromes. Multivariate analysis showed that pain was associated with age, gender and disease severity and that neuropathic pain was distinctly associated with EDSS.

Conclusions

Our study, providing definite information on the prevalence, characteristics and variables associated with neuropathic pain due to MS, shows that a more severe disease course is associated with a higher risk of neuropathic pain. Our findings might, therefore, provide a basis for improving the clinical management of this common MS complication.
Literature
1.
2.
go back to reference Solaro C, Brichetto G, Amato MP et al (2004) The prevalence of pain in multiple sclerosis: a multicenter cross-sectional study. Neurology 63(5):919–921CrossRefPubMed Solaro C, Brichetto G, Amato MP et al (2004) The prevalence of pain in multiple sclerosis: a multicenter cross-sectional study. Neurology 63(5):919–921CrossRefPubMed
3.
go back to reference O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH (2008) Pain associated with multiple sclerosis: systematic review and proposed classification. Pain 137:96–111CrossRefPubMed O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH (2008) Pain associated with multiple sclerosis: systematic review and proposed classification. Pain 137:96–111CrossRefPubMed
4.
go back to reference Truini A, Galeotti F, La Cesa S et al (2012) Mechanisms of pain in multiple sclerosis: a combined clinical and neurophysiological study. Pain 153(10):2048–2054CrossRefPubMed Truini A, Galeotti F, La Cesa S et al (2012) Mechanisms of pain in multiple sclerosis: a combined clinical and neurophysiological study. Pain 153(10):2048–2054CrossRefPubMed
5.
go back to reference Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S et al (2013) Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. 154(5):632–642CrossRefPubMed Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S et al (2013) Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. 154(5):632–642CrossRefPubMed
6.
go back to reference Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635CrossRefPubMed Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635CrossRefPubMed
7.
go back to reference Finnerup NB, Haroutounian S, Kamerman P et al (2016) Neuropathic pain: an updated grading system for research and clinical practice. Pain. 157(8):1599–1606CrossRefPubMedPubMedCentral Finnerup NB, Haroutounian S, Kamerman P et al (2016) Neuropathic pain: an updated grading system for research and clinical practice. Pain. 157(8):1599–1606CrossRefPubMedPubMedCentral
8.
go back to reference Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L et al (2010) EFNS guidelines on neurophatic pain assessment: revised 2009. Eur J Neurol 17:1010–1018CrossRefPubMed Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L et al (2010) EFNS guidelines on neurophatic pain assessment: revised 2009. Eur J Neurol 17:1010–1018CrossRefPubMed
9.
go back to reference Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al (2004) Development and validation of the Neurophatic Pain Symptom Inventorry. Pain 108:248–257CrossRefPubMed Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al (2004) Development and validation of the Neurophatic Pain Symptom Inventorry. Pain 108:248–257CrossRefPubMed
10.
go back to reference Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A et al (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114:29–36CrossRefPubMed Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A et al (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114:29–36CrossRefPubMed
11.
go back to reference Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C (2008) prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136:380–387CrossRefPubMed Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C (2008) prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136:380–387CrossRefPubMed
12.
go back to reference Moisset X, Ouchchane L, Guy N, Bayle DJ, Dallel R, Clavelou P (2013) Migraine headaches and pain with neuropathic characteristics: comorbid conditions in patients with multiple sclerosis. Pain 154:2691–2699CrossRefPubMed Moisset X, Ouchchane L, Guy N, Bayle DJ, Dallel R, Clavelou P (2013) Migraine headaches and pain with neuropathic characteristics: comorbid conditions in patients with multiple sclerosis. Pain 154:2691–2699CrossRefPubMed
13.
go back to reference Polman CH, Reingold SC, Banwell B et al (2010) Diagnostic oriteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011(69):292–302 Polman CH, Reingold SC, Banwell B et al (2010) Diagnostic oriteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011(69):292–302
14.
go back to reference Svendsen KB, Jensen TS, Overvad K et al (2003) Pain in patients with multiple sclerosis: a population-based study. Arch Neurol 60(8):1089–1094CrossRefPubMed Svendsen KB, Jensen TS, Overvad K et al (2003) Pain in patients with multiple sclerosis: a population-based study. Arch Neurol 60(8):1089–1094CrossRefPubMed
15.
go back to reference Osterberg A, Boivie J, Thuomas KA (2005) Central pain in multiple sclerosis—prevalence and clinical characteristics. Eur J Pain 9(5):531–542CrossRefPubMed Osterberg A, Boivie J, Thuomas KA (2005) Central pain in multiple sclerosis—prevalence and clinical characteristics. Eur J Pain 9(5):531–542CrossRefPubMed
16.
go back to reference Svendsen KB, Sorensen L, Jensen TS, Hansen HJ, Bach FW (2011) MRI of the central nervous system in MS patients with or without pain. Eur J Pain 15(4):395–401CrossRefPubMed Svendsen KB, Sorensen L, Jensen TS, Hansen HJ, Bach FW (2011) MRI of the central nervous system in MS patients with or without pain. Eur J Pain 15(4):395–401CrossRefPubMed
17.
go back to reference Hadjimichael O, Kerns RD, Rizzo MA et al (2007) Persistent pain and uncomfortable sensation in persons with multiple sclerosis. Pain 127(12):35–41CrossRefPubMed Hadjimichael O, Kerns RD, Rizzo MA et al (2007) Persistent pain and uncomfortable sensation in persons with multiple sclerosis. Pain 127(12):35–41CrossRefPubMed
18.
go back to reference Tsang A, Von Korff M, Lee S et al (2008) Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression anxiety disorders. J Pain 9(10):883–891CrossRefPubMed Tsang A, Von Korff M, Lee S et al (2008) Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression anxiety disorders. J Pain 9(10):883–891CrossRefPubMed
19.
go back to reference Truini A, Barbanti P, Pozzilli C et al (2013) A mechanism-based classification of pain in multiple sclerosis. J Neurol 260(2):351–367CrossRefPubMed Truini A, Barbanti P, Pozzilli C et al (2013) A mechanism-based classification of pain in multiple sclerosis. J Neurol 260(2):351–367CrossRefPubMed
20.
go back to reference Brichetto G, Messmer Uccelli M, Mancardi GL, Solaro C (2003) Symptomatic medication use in multiple sclerosis. Mult Scler 9(5):458–460CrossRefPubMed Brichetto G, Messmer Uccelli M, Mancardi GL, Solaro C (2003) Symptomatic medication use in multiple sclerosis. Mult Scler 9(5):458–460CrossRefPubMed
21.
go back to reference Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G (2017) Trigeminal neuralgia—diagnosis and treatment. Cephalalgia Int J Headache 37(7):648–657CrossRef Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G (2017) Trigeminal neuralgia—diagnosis and treatment. Cephalalgia Int J Headache 37(7):648–657CrossRef
22.
go back to reference Solaro C, Allemani C, Messmer Uccelli M, Canevari E, Dagnino N, Pizio R, Regesta G, Tanganelli P, Battaglia MA, Mancardi GL (2005) The prevalence of multiple sclerosis in the north-west Italian province of Genoa. J Neurol 252(4):436–440 (Epub 2005 Feb 23; PubMed PMID: 15726261) CrossRefPubMed Solaro C, Allemani C, Messmer Uccelli M, Canevari E, Dagnino N, Pizio R, Regesta G, Tanganelli P, Battaglia MA, Mancardi GL (2005) The prevalence of multiple sclerosis in the north-west Italian province of Genoa. J Neurol 252(4):436–440 (Epub 2005 Feb 23; PubMed PMID: 15726261) CrossRefPubMed
Metadata
Title
Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria
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
on behalf of the Neuropathic Pain Special Interest Group of the Italian Neurological Society
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 4/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-8758-2

Other articles of this Issue 4/2018

Journal of Neurology 4/2018 Go to the issue