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Beyond weakness: Characterization of pain, sensory profile and conditioned pain modulation in patients with motor neuron disease: A controlled study

Lopes, L.C.G. ; Galhardoni, R. ; Silva, V. ; Jorge, F.M.H. ; Yeng, L.T. ; Callegaro, D. ; Chadi, G. ; Teixeira, M.J. ; Ciampi de Andrade, D.

European journal of pain, 2018-01, Vol.22 (1), p.72-83 [Periódico revisado por pares]

England

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  • Título:
    Beyond weakness: Characterization of pain, sensory profile and conditioned pain modulation in patients with motor neuron disease: A controlled study
  • Autor: Lopes, L.C.G. ; Galhardoni, R. ; Silva, V. ; Jorge, F.M.H. ; Yeng, L.T. ; Callegaro, D. ; Chadi, G. ; Teixeira, M.J. ; Ciampi de Andrade, D.
  • É parte de: European journal of pain, 2018-01, Vol.22 (1), p.72-83
  • Notas: Conflicts of interest
    Funding sources
    This study was supported by the Pain Center Research Fund from the Department of Neurology, University of São Paulo, São Paulo, Brazil.
    None declared.
    ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Background Motor neuron diseases (MND) represent a group of disorders that evolve with inexorable muscle weakness and medical management is based on symptom control. However, deeper characterization of non‐motor symptoms in these patients have been rarely reported. Methods This cross‐sectional study aimed to describe non‐motor symptoms in MND and their impact on quality of life and functional status, with a focus on pain and sensory changes. Eighty patients (31 females, 55.7 ± 12.9 years old) with MND underwent a neurological examination, pain, mood, catastrophizing and psychophysics assessments [quantitative sensory testing (QST) and conditioned pain modulation (CPM)], and were compared to sex‐ and age‐matched healthy controls (HC). Results Chronic pain was present in 46% of patients (VAS =5.18 ± 2.0). Pain of musculoskeletal origin occurred in 40.5% and was mainly located in the head/neck (51%) and lower back (35%). Neuropathic pain was not present in this sample. Compared to HC, MND patients had a lower cold detection threshold (p < 0.002), and significantly lower CPM scores (4.9 ± 0.2% vs. 22.1 ± 0.2%, p = 0.012). QST/CPM results did not differ between MND patients with and without pain. Pain intensity was statistically correlated with anxiety, depression and catastrophism, and spasticity scores were inversely correlated with CPM (ρ = −0.30, p = 0.026). Conclusions Pain is frequently reported by patients with MNDs. Somatosensory and CPM changes exist in MNDs and may be related to the neurodegenerative nature of the disease. Further studies should investigate the most appropriate treatment strategies for these patients. Significance We report a comprehensive evaluation of pain and sensory abnormalities in motor neuron disease (MND) patients. We assessed the different pain syndromes present in MND with validated tools, and described the QST and conditioned pain modulation profiles in a controlled design.
  • Editor: England
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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