Longitudinal prevalence and determinants of pain in multiple sclerosis: results from the German National Multiple Sclerosis Cohort study

Item Type:	Article
Title:	Longitudinal prevalence and determinants of pain in multiple sclerosis: results from the German National Multiple Sclerosis Cohort study
Creators Name:	Heitmann, H. and Haller, B. and Tiemann, L. and Mühlau, M. and Berthele, A. and Tölle, T.R. and Salmen, A. and Ambrosius, B. and Bayas, A. and Asseyer, S. and Hartung, H.P. and Heesen, C. and Stangel, M. and Wildemann, B. and Haars, S. and Groppa, S. and Luessi, F. and Kümpfel, T. and Nischwitz, S. and Meuth, S.G. and Klotz, L. and Linker, R.A. and Zettl, U.K. and Ziemann, U. and Tumani, H. and Tackenberg, B. and Zipp, F. and Wiendl, H. and Gold, R. and Hemmer, B. and Ploner, M.
Abstract:	Pain is frequent in multiple sclerosis (MS) and includes different types, with neuropathic pain (NP) being most closely related to MS pathology. However, prevalence estimates vary largely, and causal relationships between pain and biopsychosocial factors in MS are largely unknown. Longitudinal studies might help to clarify the prevalence and determinants of pain in MS. To this end, we analyzed data from 410 patients with newly diagnosed clinically isolated syndrome or relapsing-remitting MS participating in the prospective multicenter German National MS Cohort Study (NationMS) at baseline and after 4 years. Pain was assessed by self-report using the PainDETECT Questionnaire. Neuropsychiatric assessment included tests for fatigue, depression, and cognition. In addition, sociodemographic and clinical data were obtained. Prevalence of pain of any type was 40% and 36% at baseline and after 4 years, respectively, whereas prevalence of NP was 2% and 5%. Pain of any type and NP were both strongly linked to fatigue, depression, and disability. This link was even stronger after 4 years than at baseline. Moreover, changes in pain, depression, and fatigue were highly correlated without any of these symptoms preceding the others. Taken together, pain of any type seems to be much more frequent than NP in early nonprogressive MS. Moreover, the close relationship between pain, fatigue, and depression in MS should be considered for treatment decisions and future research on a possible common pathophysiology.
Keywords:	Multiple Sclerosis, Neuropathic Pain, Epidemiology, Depression, Fatigue
Source:	Pain
ISSN:	0304-3959
Publisher:	Lippincott Williams & Wilkins
Volume:	161
Number:	4
Page Range:	787-796
Date:	April 2020
Official Publication:	https://doi.org/10.1097/j.pain.0000000000001767
PubMed:	View item in PubMed

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