Neuropathic pain in multiple sclerosis
Author(s): ,
C.A Young
Affiliations:
Walton Centre NHS Trust;University of Liverpool, Liverpool
,
R.J Mills
Affiliations:
Royal Preston Hospital, Preston, United Kingdom
,
A Tennant
Affiliations:
Swiss Paraplegic Research, Nottwil, Switzerland
TONiC Study Group
TONiC Study Group
Affiliations:
ECTRIMS Online Library. Young C. 09/15/16; 146178; P337
Prof. Carolyn Young
Prof. Carolyn Young
Contributions
Abstract

Abstract: P337

Type: Poster

Abstract Category: Clinical aspects of MS - MS symptoms

Introduction: Neuropathic pain (NP) refers to pain arising as a direct consequence of a lesion or disease affecting the somatosensory system [1]. Its prevalence in Multiple Sclerosis has been reported as over 28% [2]. It has been shown to have considerable impact upon the various domains of health status [3].

Methods: 722 people with MS were recruited into the early stages of the longitudinal TONiC study. Each completed a questionnaire booklet with a range of scales, including the Neuropathic Pain Scale (NPS) [1].

Results: Mean age was 48.9 years (SD 11.6) with mean disease duration of 11.5 years (SD 9.1). Just under a third (32.1%) had a progressive form of MS. Almost two thirds (62%) had an EDSS of 4.5 or greater.

65.9% reported some aspect of NP (i.e. NPS>0). No difference was found in the NPS by age (Kruskal Wallis; p>0.642) or by gender (Mann Whitney p=>0.584). However, a significant difference was found for duration, incorporating a u-shaped curve, such that with those whose duration was less than 5 years, and those exceeding 17 years experienced the highest NP (Kruskal Wallis p=0.045). A significant gradient was also observed for disease subtype, where those with Secondary Progressive MS (SP) showed the highest levels of NP (Kruskal Wallis; p < 0.001). This may account for the u-shaped pattern to duration, as those with SP have the longest duration (F 55.3; p=< 0.001). A strong gradient was also observed for EDSS (Kruskal Wallis; p < 0.001). Significantly higher levels of NP were also reported for those not working (Mann Whitney U; p= 0.001). For those with an NPS score in the upper third of its range, the odds of being in work, adjusted for age, was reduced by 3.8 times.

Conclusion: Symptoms consistent with NP are common in MS, and in the current study almost two-thirds of respondents reported some such symptoms. Strong gradients of NP were observed across many clinical attributes, as well as for work status.

1. Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology 1997;48(2):332-8.

2. Foley PL, Vesterinen HM, Laird BJ, Sena ES et al. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain 2013;154(5):632-42.

3.Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic pain on health-related quality of life: review and implications. Neurology 2007;68(15):1178-82.

Disclosure:

Carolyn Young has received honoraria and travel expenses for scientific meetings and advisory boards, or grants from Bayer, Biogen Idec, Merck Serono, Genzyme, Motor Neurone Disease Association, MS Trust, National Institute for Health Research, Novartis, Roche, Teva, and Wellcome Trust.

Roger Mills has received conference expenses from Biogen Idec and Teva.

Alan Tennant : nothing to disclose.

Abstract: P337

Type: Poster

Abstract Category: Clinical aspects of MS - MS symptoms

Introduction: Neuropathic pain (NP) refers to pain arising as a direct consequence of a lesion or disease affecting the somatosensory system [1]. Its prevalence in Multiple Sclerosis has been reported as over 28% [2]. It has been shown to have considerable impact upon the various domains of health status [3].

Methods: 722 people with MS were recruited into the early stages of the longitudinal TONiC study. Each completed a questionnaire booklet with a range of scales, including the Neuropathic Pain Scale (NPS) [1].

Results: Mean age was 48.9 years (SD 11.6) with mean disease duration of 11.5 years (SD 9.1). Just under a third (32.1%) had a progressive form of MS. Almost two thirds (62%) had an EDSS of 4.5 or greater.

65.9% reported some aspect of NP (i.e. NPS>0). No difference was found in the NPS by age (Kruskal Wallis; p>0.642) or by gender (Mann Whitney p=>0.584). However, a significant difference was found for duration, incorporating a u-shaped curve, such that with those whose duration was less than 5 years, and those exceeding 17 years experienced the highest NP (Kruskal Wallis p=0.045). A significant gradient was also observed for disease subtype, where those with Secondary Progressive MS (SP) showed the highest levels of NP (Kruskal Wallis; p < 0.001). This may account for the u-shaped pattern to duration, as those with SP have the longest duration (F 55.3; p=< 0.001). A strong gradient was also observed for EDSS (Kruskal Wallis; p < 0.001). Significantly higher levels of NP were also reported for those not working (Mann Whitney U; p= 0.001). For those with an NPS score in the upper third of its range, the odds of being in work, adjusted for age, was reduced by 3.8 times.

Conclusion: Symptoms consistent with NP are common in MS, and in the current study almost two-thirds of respondents reported some such symptoms. Strong gradients of NP were observed across many clinical attributes, as well as for work status.

1. Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology 1997;48(2):332-8.

2. Foley PL, Vesterinen HM, Laird BJ, Sena ES et al. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain 2013;154(5):632-42.

3.Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic pain on health-related quality of life: review and implications. Neurology 2007;68(15):1178-82.

Disclosure:

Carolyn Young has received honoraria and travel expenses for scientific meetings and advisory boards, or grants from Bayer, Biogen Idec, Merck Serono, Genzyme, Motor Neurone Disease Association, MS Trust, National Institute for Health Research, Novartis, Roche, Teva, and Wellcome Trust.

Roger Mills has received conference expenses from Biogen Idec and Teva.

Alan Tennant : nothing to disclose.

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