Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
Norfolk and Norwich University Hospital, Norwich, UK.
Amyotroph Lateral Scler Frontotemporal Degener. 2021 Nov;22(7-8):449-458. doi: 10.1080/21678421.2021.1892765. Epub 2021 Mar 4.
Physical pain is a known symptom in amyotrophic lateral sclerosis (ALS), but no systematically derived prevalence estimate is available. The aim of this study was to determine the pooled prevalence of pain in ALS, relative to its method of measurement and pain characteristics. : A systematic search across multiple databases was conducted on January 16, 2020. Random-effects meta-analyses of single proportions were performed on prevalence data. Heterogeneity was determined using the statistic. Where available, pain location, intensity, and type or source were compared. 2552 articles were identified. Twenty-one eligible studies were included. All studies used observational designs (14 cross-sectional, 6 cohort, 1 case-control). Pooled prevalence of pain in ALS across all studies was 60% (95% CI = 50-69%), with a high degree of heterogeneity ( = 94%, < .001). Studies that used only validated measures had lower heterogeneity ( = 82%, = 0.002), compared to those that used tailored measures, or tailored supplemented with validated measures ( = 90%, < 0.001 and = 83%, < 0.001, respectively). In a subset of studies ( = 9), the most commonly reported pain location was the upper limbs including shoulders/extremities (41.5%). A further study subset ( = 7) showed moderate-severe intensity pain was most frequently reported. Type of pain was commonly related to cramp or spasm. Experiencing physical pain in ALS occurs with high prevalence. Deriving consensus on which specific tools should be used to assess, monitor and compare symptoms of pain in this population will reduce current heterogeneity in approaches and increase the likelihood of ameliorating distressing experiences more effectively.
身体疼痛是肌萎缩侧索硬化症（ALS）的已知症状，但尚无系统得出的患病率估计值。本研究旨在确定 ALS 疼痛的汇总患病率，相对于其测量方法和疼痛特征。：2020 年 1 月 16 日在多个数据库中进行了系统搜索。对患病率数据进行了单比例的随机效应荟萃分析。使用 Q 统计量确定异质性。在可用的情况下，比较了疼痛位置、强度以及类型或来源。共确定了 2552 篇文章。有 21 项符合条件的研究被纳入。所有研究均采用观察性设计（14 项横断面研究，6 项队列研究，1 项病例对照研究）。所有研究中 ALS 疼痛的汇总患病率为 60%（95%CI=50-69%），异质性程度较高（ = 94%， <.001）。仅使用经过验证的测量方法的研究异质性较低（ = 82%， = 0.002），而仅使用定制测量方法或定制补充经过验证的测量方法的研究异质性较高（ = 90%， < 0.001 和 = 83%， < 0.001）。在一部分研究中（ n = 9），最常报告的疼痛部位是上肢，包括肩膀/四肢（41.5%）。另一部分研究（ n = 7）表明，中度至重度强度疼痛最常被报告。疼痛类型通常与抽筋或痉挛有关。在 ALS 中经历身体疼痛的发生率很高。就应该使用哪些特定工具来评估、监测和比较该人群的疼痛症状达成共识，将减少目前方法上的异质性，并增加更有效地减轻痛苦体验的可能性。
