Department of Rehabilitation, Mons Luigi Novarese Novarese, Moncrivello, Italy.
Department of Neurology, ASL3 Genovese, Genoa, Italy.
J Neurol. 2018 Apr;265(4):828-835. doi: 10.1007/s00415-018-8758-2. Epub 2018 Feb 5.
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.
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.
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.
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.
疼痛是多发性硬化症（MS）的一种常见且具有异质性的并发症。在这项多中心、横断面研究中，我们旨在使用区分不同类型疼痛的高度特异性标准来调查 MS 患者疼痛的患病率。
在进行结构化访谈后，对有疼痛的患者使用临床检查和 DN4 问卷来区分神经病理性疼痛和伤害性疼痛。在有神经病理性疼痛的患者中，使用神经病理性疼痛症状量表来区分神经病理性疼痛症状。
我们共纳入 1249 名参与者（832 名女性，417 名男性，平均年龄 33.9 岁，平均病程 8 年，平均 EDSS 3.2）；根据临床评估和 DN4 评分，429 名患者（34.34%）被归类为有疼痛（470 种疼痛综合征）：286 种伤害性疼痛综合征和 184 种神经病理性疼痛综合征。多变量分析表明，疼痛与年龄、性别和疾病严重程度有关，而神经病理性疼痛与 EDSS 明显相关。
我们的研究提供了关于多发性硬化症引起的疼痛的患病率、特征和与神经病理性疼痛相关的变量的明确信息，表明更严重的疾病过程与神经病理性疼痛的风险增加相关。因此，我们的研究结果可能为改善这种常见的多发性硬化症并发症的临床管理提供依据。
