Universidade Federal Fluminense, Hospital Universitário Antônio Pedro, Departamento de Neurologia, Niterói RJ, Brasil.
Arq Neuropsiquiatr. 2021 May;79(5):415-419. doi: 10.1590/0004-282X-ANP-2020-0132.
Charcot-Marie-Tooth disease type 1A (CMT1A) is the most common form of hereditary neuropathy.
To investigate the prevalence and characteristics of pain in patients with CMT1A.
Nineteen patients with a diagnosis of CMT1A were evaluated between September 2018 and October 2019, and other causes of neuropathy were ruled out. The following tools were used for the pain assessment: neurological assessment, LANSS, DN4, clinical evaluation, VAS, CMTNS2 and SF-36. Statistical analysis was performed using prevalence analysis, t test, chi-square test and Spearman's rho.
The prevalence of pain was 84.2% in the sample of this study, with moderate intensity and nociceptive characteristics according to the LANSS scale (75%) and clinical evaluation (50%), but differing from DN4, which found neuropathic pain in the majority of the patients (56.2%). Mixed pain was also observed in 43.7% of the patients, according to clinical criteria. There was a statistically significant correlation between pain intensity and SF-36, thus demonstrating that the lower the pain was, the lower the impairment was, in all domains.
Pain is a prevalent and important symptom in CMT1A, with moderate intensity and nociceptive characteristics according to two tools, but neuropathic pain is also present, and there may even be a mixed pattern of pain. The correlation of the pain with SF-36 suggests that pain relief could provide improvements to the quality of life of these individuals.
Charcot-Marie-Tooth 病 1A 型(CMT1A)是最常见的遗传性周围神经病。
调查 CMT1A 患者疼痛的患病率和特征。
2018 年 9 月至 2019 年 10 月间评估了 19 例 CMT1A 患者,并排除了其他神经病变的原因。采用以下工具进行疼痛评估:神经学评估、LANSS、DN4、临床评估、VAS、CMTNS2 和 SF-36。采用患病率分析、t 检验、卡方检验和斯皮尔曼 rho 进行统计学分析。
在本研究样本中,疼痛的患病率为 84.2%,根据 LANSS 量表(75%)和临床评估(50%),疼痛强度为中度,具有伤害感受性特征,但与 DN4 不同,DN4 发现大多数患者存在神经病理性疼痛(56.2%)。根据临床标准,还观察到混合性疼痛占 43.7%。疼痛强度与 SF-36 之间存在统计学显著相关性,因此表明疼痛越低,所有领域的损伤越低。
疼痛是 CMT1A 的一种常见且重要的症状,根据两种工具,疼痛强度为中度,具有伤害感受性特征,但也存在神经病理性疼痛,甚至可能存在混合性疼痛模式。疼痛与 SF-36 的相关性表明,缓解疼痛可能会提高这些患者的生活质量。