Neuropathic pain component in patients with myotonic dystrophy type 2 – a pilot study

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Authors: O. Parmová ¹; E. Vlčková ^1,2; J. Bednařík ^1,2; S. Voháňka ^1,2
Authors place of work: Neurologická klinika LF MU a FN Brno ¹; CEITEC – Středoevropský technologický institut, Brno ²
Published in the journal: Cesk Slov Neurol N 2019; 82(3): 322-332
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019322

Summary

Aim: Patients with myotonic dystrophy (MD) may suffer from variable types of pain and some descriptors suggest the involvement of a possible neuropathic pain component in MD patients. The aim of the study was to evaluate the occurrence of neuropathic pain descriptors and sensory abnormalities in patients with myotonic dystrophy type 2 (MD2) and to disclose the presence of some relevant psychological factors in chronic pain conditions.

Patients and methods: A group of 23 patients with MD2 suffering from chronic pain and a group of 24 age- and gender-matched healthy controls were examined using the PainDETECT questionnaire and the Neuropathic Pain Symptom Inventory questionnaire (NPSI), a comprehensive protocol of quantitative sensory testing (QST) and a battery of self-reported psychological tests.

Results: Based on the PainDETECT questionnaire, the presence of a neuropathic component of pain was evaluated as possible or probable in more than half of the patients. According to the NPSI questionnaire, the most frequently described spontaneous pain in patients with MD2 was squeezing. Very common are brief pain attacks of stabbing pain, and two thirds of patients also described abnormal sensations (pins and needles and/or tingling) in the painful area. QST in lower legs showed significantly more frequent hypoesthesia for cold and hyperalgesia for mechanical pain stimuli and also higher incidence of paradoxical heat sensation. Patients with MD2 also showed significantly more frequent depression and pain catastrophizing.

Conclusion: The pain descriptors evaluated by PainDETECT and NPSI questionnaires, and sensory profile assessed by the QST protocol performed in this pilot study support the hypothesis that pain in MD2 patients probably has a neuropathic component.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

强直性肌营养不良2型患者神经性疼痛成分的初步研究

目的:

强直性肌营养不良(MD)患者可能会遭受不同类型的疼痛，一些描述符表明，MD患者可能涉及一种神经性疼痛成分。本研究旨在评估2型强直性肌营养不良(MD2)患者神经性疼痛描述符和感觉异常的发生情况，并揭示慢性疼痛状态下相关心理因素的存在。

患者和方法:

一群23 MD2患者遭受慢性疼痛和一群24岁——准确性健康对照检查库存使用PainDETECT问卷和神经性疼痛症状问卷(NPSI),一个全面的协议的定量感觉测试(QST)和自我心理测试的电池。

结果:

根据疼痛检测问卷，一半以上的患者可能存在或可能存在疼痛的神经病理性成分。根据NPSI问卷调查，描述MD2患者自发性疼痛最常见的是挤压。很常见的是刺痛的短暂疼痛发作，三分之二的患者还描述了疼痛区域的异常感觉(针刺和/或刺痛)。下肢QST表现为明显的冷觉过敏和机械痛刺激痛觉过敏，以及较高的反常热感觉发生率。MD2患者也明显表现出更频繁的抑郁和疼痛恶化。

结论:

通过疼痛检测和NPSI问卷评估的疼痛描述符，以及在本试点研究中执行的QST方案评估的感觉特征，支持MD2患者的疼痛可能有神经病理性成分的假设。

关键词:

强直性肌营养不良-疼痛-神经性疼痛-描述符-心理学

Keywords:

myotonic dystrophy – Pain – Neuropathic pain – descriptors – Psychology

Zdroje

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