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. 2020 Jan;16(1):124-130.
doi: 10.3988/jcn.2020.16.1.124.

Comparison of Neuropathic Pain in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis

Jae Won Hyun  1 , Hyunmin Jang  1 , JaeBin Yu  1 , Na Young Park  1 , Su Hyun Kim  1 , So Young Huh  2 , Woojun Kim  3 , Min Su Park  4 , Jeeyoung Oh  5 , Kee Duk Park  6 , Ho Jin Kim  7
Affiliations

Comparison of Neuropathic Pain in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis

Jae Won Hyun et al. J Clin Neurol. 2020 Jan.

Abstract

Background and purpose: To compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).

Methods: From 2016 to 2018, 500 patients with NMOSD and MS from 6 referral hospitals in Korea underwent pain investigation. After the patients with current pain were matched for sex ratio and disease duration as confounding factors, PainDETECT questionnaires were assessed in 99 NMOSD and 58 MS patients to investigate neuropathic pain. The short form of the Brief Pain Inventory from 74 patients with neuropathic pain component was also analysed.

Results: According to the PainDETECT questionnaire, mechanical allodynia (p=0.014) and thermal hyperalgesia (p=0.011) were more severe in NMOSD patients than in MS patients. Strong involvements (score >3) of the pain in domains of tingling/prickling sensation (p=0.024), mechanical allodynia (p=0.027), sudden pain attacks (p=0.018), and thermal hyperalgesia (p=0.002) were significantly more frequent in NMOSD compared to MS patients. Among the patients experiencing pain with a neuropathic component, total pain-related interference (p=0.045) scores were significantly higher in NMOSD patients than in MS patients. In daily life, pain interfered with normal work (p=0.045) and relationships with other people (p=0.039) more often in NMOSD patients than in MS patients. Although pain medication was prescribed more frequently in NMOSD patients, the percentage of patients experiencing medication-related pain relief was lower in those patients.

Conclusions: The severity of neuropathic pain and the pain-related interference in daily life were greater in NMOSD patients than in MS patients. Individualized analgesic management should be considered based on a comprehensive understanding of neuropathic pain in these patients.

Keywords: multiple sclerosis; neuromyelitis optica spectrum disorder; neuropathic pain.

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Conflict of interest statement

Jang H, Yu J, Park NY, Huh, Kim W, Park MS, Oh J, Park KD report no financial disclosures. Hyun JW has received a grant from the National Research Foundation of Korea. Kim SH has lectured, consulted, and received honoraria from Bayer Schering Pharma, Biogen, Genzyme, Merck Serono, and UCB and received a grant from the National Research Foundation of Korea. Kim HJ has lectured, consulted, and received honoraria from Bayer Schering Pharma, Biogen, Celltrion, Eisai, HanAll BioPharma, Merck Serono, Novartis, Sanofi Genzyme, Teva-Handok, and UCB; received a grant from the National Research Foundation of Korea; and accepted research funding from Sanofi Genzyme, Teva-Handok, and UCB; serves on a steering committee for MedImmune/VielaBio; is a co-editor for the Multiple Sclerosis Journal-Experimental, Translational, and Clinical, and an associated editor for the Journal of Clinical Neurology.

Figures

Fig. 1
Fig. 1. Flow chart of the pain investigation in this study. BPI: brief pain inventory, NMOSD: neuromyelitis optica spectrum disorder, MS: multiple sclerosis.
See this image and copyright information in PMC

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