Clermont Université, Université d'Auvergne, Neuro-Dol;Inserm U1107, Douleur Trigéminale et Migraine, Faculté de chirurgie dentaire, Clermont-Ferrand F-63000, France Clermont Université, Université d'Auvergne, CHU Clermont-Ferrand, Service de Neurologie, CHU Gabriel Montpied, Clermont-Ferrand F-63000, France Clermont Université, Université d'Auvergne, CHU Clermont-Ferrand, Service de Biostatistiques, CHU Gabriel Montpied, Clermont-Ferrand F-63000, France Clermont Université, Université d'Auvergne, UMR 6284 UdA-CNRS, ISIT, Science de l'Image pour Techniques Interventionnelles, Clermont-Ferrand F-63000, France Clermont Université, Université d'Auvergne, CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand F-63000, France.
Pain. 2013 Dec;154(12):2691-2699. doi: 10.1016/j.pain.2013.07.050. Epub 2013 Aug 2.
We conducted a postal survey to assess the prevalence and characteristics of neuropathic pain and migraine in a cohort of multiple sclerosis (MS) patients. Of the 1300 questionnaires sent, 673 could be used for statistical analysis. Among the respondents, the overall pain prevalence in the previous month was 79%, with 51% experiencing pain with neuropathic characteristics (NCs) and 46% migraine. MS patients with both migraine and NC pain (32% of the respondents) reported more severe pain and had lower health-related quality of life than MS patients with either migraine or NC pain. Pain intensity in MS patients with migraine was moderate (6.0 ± 0.1). Migraine was mostly episodic, but headaches were occurring on ≥15 days per month in 15% of those with migraine. MS patients with migraine were younger and had shorter disease durations than those with NC pain. NC pain was most often located in the extremities, back and head, and was frequently described as tingling and pins-and-needles. The intensity of NC pain was low to moderate (4.9 ± 0.1), but positively correlated with the number of painful body sites. Nonetheless, patients with NC pain were more disabled (with a higher Expanded Disability Status Scale and pain interference index) than patients with migraine. Migraine, but not NC pain, was associated with age, disease duration, relapsing-remitting course, and interferon-beta treatment. This suggests that NC pain and migraine are mediated by different mechanisms. Therefore, pain mechanisms that specifically operate in MS patients need to be characterized to design optimal treatments for these individuals.
我们进行了一项邮寄调查，以评估多发性硬化症（MS）患者队列中神经性疼痛和偏头痛的患病率和特征。在发送的 1300 份问卷中，有 673 份可用于统计分析。在回答者中，前一个月的总体疼痛患病率为 79%，其中 51%有神经性疼痛特征（NC），46%有偏头痛。同时患有偏头痛和 NC 疼痛的 MS 患者（占回答者的 32%）报告的疼痛更严重，健康相关生活质量较低，而同时患有偏头痛和 NC 疼痛的 MS 患者。偏头痛患者的疼痛强度为中度（6.0±0.1）。偏头痛大多是发作性的，但有 15%的偏头痛患者头痛每月发作≥15 天。偏头痛患者比 NC 疼痛患者年轻，病程较短。NC 疼痛最常位于四肢、背部和头部，常被描述为刺痛和刺痛感。NC 疼痛的强度为低至中度（4.9±0.1），但与疼痛部位的数量呈正相关。尽管如此，NC 疼痛患者的残疾程度（更高的扩展残疾状态量表和疼痛干扰指数）高于偏头痛患者。偏头痛而不是 NC 疼痛与年龄、病程、复发缓解病程和干扰素-β治疗有关。这表明 NC 疼痛和偏头痛是由不同的机制介导的。因此，需要对多发性硬化症患者中特定运作的疼痛机制进行特征描述，以设计针对这些患者的最佳治疗方法。
