Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Eur J Neurol. 2021 May;28(5):1645-1658. doi: 10.1111/ene.14729. Epub 2021 Feb 11.
Myelin oligodendrocyte glycoprotein-antibody-associated disease (MOGAD) is an inflammatory autoimmune condition of the central nervous system. However, data on pain and depression have remained scarce. The aim of this study was to assess features of chronic pain and depression as well as their impact on health-related quality of life (hr-QoL) in MOGAD.
Patients with MOGAD were identified in the Neuromyelitis Optica Study Group registry. Data were acquired by a questionnaire, including clinical, demographic, pain (PainDetect, Brief Pain Inventory-Short Form, McGill Pain Questionnaire-Short Form), depression (Beck Depression Inventory-II), and hr-QoL (Short Form-36 Health Survey) items.
Twenty-two of 43 patients suffered from MOGAD-related pain (11 nociceptive, eight definite neuropathic, three possible neuropathic) and 18 from depression. Patients with neuropathic pain had the highest pain intensity and most profound activities of daily living (ADL) impairment. Fifteen patients reported spasticity-associated pain, including four with short-lasting painful tonic spasms. Later disease onset, profound physical impairment, and depression were associated with chronic pain. Physical QoL was more affected in pain sufferers (p < 0.001) than in pain-free patients, being most severely reduced by neuropathic pain (p = 0.016). Pain severity, visual impairment, and gait impairment independently predicted lower physical QoL. Depression was the only factor reducing mental QoL. Twelve patients still suffering from moderate pain (pain severity 4.6 ± 2.3) received pain medication. Only four out of 10 patients with moderate to severe depression took antidepressants.
Being highly prevalent, pain and depression strongly affect QoL and ADL in MOGAD. Both conditions remain insufficiently controlled in real-life clinical practice.
髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是一种中枢神经系统的炎症性自身免疫性疾病。然而，有关疼痛和抑郁的数据仍然很少。本研究的目的是评估 MOGAD 患者慢性疼痛和抑郁的特征及其对健康相关生活质量（hr-QoL）的影响。
在视神经脊髓炎研究组的登记处确定了 MOGAD 患者。通过问卷获取数据，包括临床、人口统计学、疼痛（疼痛检测、简明疼痛量表-短表、麦吉尔疼痛问卷-短表）、抑郁（贝克抑郁量表-II）和 hr-QoL（简明 36 健康调查）项目。
43 例患者中有 22 例患有 MOGAD 相关疼痛（11 例为伤害性疼痛，8 例为明确的神经性疼痛，3 例为可能的神经性疼痛），18 例患有抑郁。患有神经性疼痛的患者疼痛强度最高，日常生活活动（ADL）受损最严重。15 例患者报告了痉挛相关疼痛，其中 4 例伴有短暂性疼痛性强直性痉挛。疾病后期发病、严重的身体功能障碍和抑郁与慢性疼痛有关。疼痛患者的身体 QoL 受影响更严重（p<0.001），而无疼痛患者的身体 QoL 受影响更严重，神经病理性疼痛患者的身体 QoL 受影响最严重（p=0.016）。疼痛严重程度、视力障碍和步态障碍独立预测身体 QoL 降低。抑郁是唯一降低心理健康 QoL 的因素。12 例仍有中度疼痛（疼痛严重程度 4.6±2.3）的患者接受了疼痛药物治疗。只有 10 例中重度抑郁患者中的 4 例服用了抗抑郁药。
疼痛和抑郁在 MOGAD 中非常普遍，严重影响 QoL 和 ADL。这两种情况在现实临床实践中都没有得到充分控制。
