Buono Frank D, Grau Lauretta E, Sprong Matthew E, Morford Kenneth L, Johnson Kimberly J, Gutmann David H
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
J Pain Res. 2019 Aug 22;12:2555-2561. doi: 10.2147/JPR.S209540. eCollection 2019.
Neurofibromatosis type 1 (NF1) is a neurogenetic disorder affecting 1 in 3000 people worldwide, where individuals are prone to develop benign and malignant tumors. In addition, many people with NF1 complain of pain that limits their daily functioning. Due to the complexity of the disorder, there are few options for treating pain symptoms besides surgery and medications. Moreover, the spectrum of pain symptomatology and treatment, as well as the mechanisms underlying NF1-associated pain, has been understudied.
To address this knowledge gap, we conducted a survey of 255 adults with NF1, leveraging the Washington University NF1 Patient Registry Initiative (NPRI) database. Demographic and pain data were collected using a Qualtrics survey.
All participants had at least one surgical procedure, with 55% reporting having at least one surgery within the last year and 17% being currently prescribed opioid medication. A positive relationship was shown (<0.001) between those prescribed prescription pain medication, and their pain severity and interference. Moreover, there was a significant relationship (=0.049) between the usage of complementary treatments and pain severity and interference.
The current study demonstrates that individuals with NF1 report a higher incidence of pain severity and interference than observed in NF1 previous studies, with pain symptoms not localized to any specific region of the body. The consideration for alternative treatments and careful monitoring of current treatments that are more conservative or have less potential adverse side effects may improve pain management and reduce the risk of developing medication dependence.
1型神经纤维瘤病(NF1)是一种神经遗传性疾病,全球每3000人中就有1人受其影响,患者容易患上良性和恶性肿瘤。此外,许多NF1患者抱怨疼痛限制了他们的日常活动。由于该疾病的复杂性,除了手术和药物治疗外,治疗疼痛症状的选择很少。此外,NF1相关疼痛的症状学和治疗范围以及潜在机制尚未得到充分研究。
为了填补这一知识空白,我们利用华盛顿大学NF1患者登记计划(NPRI)数据库,对255名成年NF1患者进行了一项调查。使用Qualtrics调查问卷收集人口统计学和疼痛数据。
所有参与者都至少接受过一次外科手术,55%的人报告在过去一年中至少接受过一次手术,17%的人目前正在服用阿片类药物。服用处方止痛药的患者与其疼痛严重程度和干扰之间呈正相关(<0.001)。此外,辅助治疗的使用与疼痛严重程度和干扰之间存在显著关系(=0.049)。
当前研究表明,与之前的NF1研究相比,NF1患者报告的疼痛严重程度和干扰发生率更高,疼痛症状并不局限于身体的任何特定区域。考虑采用替代治疗方法,并仔细监测更保守或潜在副作用较小的现有治疗方法,可能会改善疼痛管理,并降低产生药物依赖的风险。