Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, 1 Bowdoin Square, Suite 100, 1st Floor, Boston, MA, 02114, USA.
Harvard Medical School, Boston, MA, 02115, USA.
J Neurooncol. 2021 Sep;154(2):257-263. doi: 10.1007/s11060-021-03826-3. Epub 2021 Aug 19.
Neurofibromatoses (NFs; NF1, NF2 and Schwannomatosis) are incurable genetic syndromes characterized by nerve sheath tumors and often accompanied by substantial emotional distress (e.g., depression and anxiety). Pain is also common but understudied in adults with NF and interferes with daily living. In other medical populations, depression and anxiety have a strong association with pain interference. However, research has not explored the relationship of depression and anxiety to pain interference among adults with NF experiencing pain. The aim of this study was to test the hypothesis that depression and anxiety will mediate the association between pain intensity and pain interference among geographically diverse adults with NF who endorse pain.
We used baseline data from an RCT of a mind-body intervention aimed at improving quality of life in adults with NF. Participants (N = 214) who endorsed pain completed measures of demographics, clinical characteristics, baseline pain intensity, pain interference, depression, and anxiety. We constructed a multiple mediation model in R using the lavaan package to test our hypothesis.
Preliminary analyses showed differences in pain interference by NF diagnostic subtype (F(2, 206) = 6.82, p = 001). In a model that controlled for NF diagnostic subtype, we found that depression (β = .07, p = .017), but not anxiety (β = -.003, p = .878), partially mediated the association between pain intensity and pain interference.
Improving depression has the potential to decrease pain interference among people with NF who experience pain.
Clinicaltrials.gov Registration #: NCT03406208.
神经纤维瘤病（NF；NF1、NF2 和神经鞘瘤病）是无法治愈的遗传性综合征，其特征为神经鞘瘤，常伴有严重的情绪困扰（例如抑郁和焦虑）。疼痛在 NF 患者中也很常见，但研究较少。在其他医学人群中，抑郁和焦虑与疼痛干扰有很强的关联。然而，研究尚未探讨 NF 患者疼痛与抑郁和焦虑之间的关系。本研究旨在检验以下假设：抑郁和焦虑将在经历疼痛的 NF 成年患者中，调节疼痛强度与疼痛干扰之间的关系。
我们使用旨在改善 NF 成年患者生活质量的身心干预 RCT 的基线数据。报告疼痛的参与者（N=214）完成了人口统计学、临床特征、基线疼痛强度、疼痛干扰、抑郁和焦虑的评估。我们使用 lavaan 包在 R 中构建了一个多重中介模型来检验我们的假设。
初步分析显示，NF 诊断亚型之间的疼痛干扰存在差异（F(2, 206)=6.82，p=0.017）。在控制 NF 诊断亚型的模型中，我们发现抑郁（β=0.07，p=0.017），但不是焦虑（β=-0.003，p=0.878），部分中介了疼痛强度与疼痛干扰之间的关系。
改善抑郁可能会降低 NF 患者疼痛干扰的程度。
Clinicaltrials.gov 注册号：NCT03406208。
