Pain, Depression, and Quality of Life in Neuromyelitis Optica Spectrum Disorder
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Pain, Depression, and Quality of Life in Neuromyelitis Optica Spectrum Disorder : A Cross-Sectional Study of 166 AQP4 Antibody-Seropositive Patients. / Ayzenberg, Ilya; Richter, Daniel; Henke, Eugenia; Asseyer, Susanna; Paul, Friedemann; Trebst, Corinna; Hümmert, Martin W; Havla, Joachim; Kümpfel, Tania; Ringelstein, Marius; Aktas, Orhan; Wildemann, Brigitte; Jarius, Sven; Häußler, Vivien; Stellmann, Jan-Patrick; Senel, Makbule; Klotz, Luisa; Pellkofer, Hannah L; Weber, Martin S; Pawlitzki, Marc; Rommer, Paulus S; Berthele, Achim; Wernecke, Klaus-Dieter; Hellwig, Kerstin; Gold, Ralf; Kleiter, Ingo; NEMOS (Neuromyelitis Optica Study Group).
In: NEUROL-NEUROIMMUNOL, Vol. 8, No. 3, e985, 05.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Pain, Depression, and Quality of Life in Neuromyelitis Optica Spectrum Disorder
T2 - A Cross-Sectional Study of 166 AQP4 Antibody-Seropositive Patients
AU - Ayzenberg, Ilya
AU - Richter, Daniel
AU - Henke, Eugenia
AU - Asseyer, Susanna
AU - Paul, Friedemann
AU - Trebst, Corinna
AU - Hümmert, Martin W
AU - Havla, Joachim
AU - Kümpfel, Tania
AU - Ringelstein, Marius
AU - Aktas, Orhan
AU - Wildemann, Brigitte
AU - Jarius, Sven
AU - Häußler, Vivien
AU - Stellmann, Jan-Patrick
AU - Senel, Makbule
AU - Klotz, Luisa
AU - Pellkofer, Hannah L
AU - Weber, Martin S
AU - Pawlitzki, Marc
AU - Rommer, Paulus S
AU - Berthele, Achim
AU - Wernecke, Klaus-Dieter
AU - Hellwig, Kerstin
AU - Gold, Ralf
AU - Kleiter, Ingo
AU - NEMOS (Neuromyelitis Optica Study Group)
N1 - Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
PY - 2021/5
Y1 - 2021/5
N2 - OBJECTIVES: To evaluate prevalence, clinical characteristics, and predictors of pain, depression, and their impact on the quality of life (QoL) in a large neuromyelitis optica spectrum disorder (NMOSD) cohort.METHODS: We included 166 patients with aquaporin-4-seropositive NMOSD from 13 tertiary referral centers. Patients received questionnaires on demographic and clinical characteristics, PainDetect, short form of Brief Pain Inventory, Beck Depression Inventory-II, and Short Form 36 Health Survey.RESULTS: One hundred twenty-five (75.3%) patients suffered from chronic NMOSD-associated pain. Of these, 65.9% had neuropathic pain, 68.8% reported spasticity-associated pain and 26.4% painful tonic spasms. Number of previous myelitis attacks (OR = 1.27, p = 0.018) and involved upper thoracic segments (OR = 1.31, p = 0.018) were the only predictive factors for chronic pain. The latter was specifically associated with spasticity-associated pain (OR = 1.36, p = 0.002). More than a third (39.8%) suffered from depression, which was moderate to severe in 51.5%. Pain severity (OR = 1.81, p < 0.001) and especially neuropathic character (OR = 3.44, p < 0.001) were associated with depression. Pain severity and walking impairment explained 53.9% of the physical QoL variability, while depression and walking impairment 39.7% of the mental QoL variability. No specific medication was given to 70.6% of patients with moderate or severe depression and 42.5% of those with neuropathic pain. Two-thirds (64.2%) of patients with symptomatic treatment still reported moderate to severe pain.CONCLUSIONS: Myelitis episodes involving upper thoracic segments are main drivers of pain in NMOSD. Although pain intensity was lower than in previous studies, pain and depression remain undertreated and strongly affect QoL. Interventional studies on targeted treatment strategies for pain are urgently needed in NMOSD.
AB - OBJECTIVES: To evaluate prevalence, clinical characteristics, and predictors of pain, depression, and their impact on the quality of life (QoL) in a large neuromyelitis optica spectrum disorder (NMOSD) cohort.METHODS: We included 166 patients with aquaporin-4-seropositive NMOSD from 13 tertiary referral centers. Patients received questionnaires on demographic and clinical characteristics, PainDetect, short form of Brief Pain Inventory, Beck Depression Inventory-II, and Short Form 36 Health Survey.RESULTS: One hundred twenty-five (75.3%) patients suffered from chronic NMOSD-associated pain. Of these, 65.9% had neuropathic pain, 68.8% reported spasticity-associated pain and 26.4% painful tonic spasms. Number of previous myelitis attacks (OR = 1.27, p = 0.018) and involved upper thoracic segments (OR = 1.31, p = 0.018) were the only predictive factors for chronic pain. The latter was specifically associated with spasticity-associated pain (OR = 1.36, p = 0.002). More than a third (39.8%) suffered from depression, which was moderate to severe in 51.5%. Pain severity (OR = 1.81, p < 0.001) and especially neuropathic character (OR = 3.44, p < 0.001) were associated with depression. Pain severity and walking impairment explained 53.9% of the physical QoL variability, while depression and walking impairment 39.7% of the mental QoL variability. No specific medication was given to 70.6% of patients with moderate or severe depression and 42.5% of those with neuropathic pain. Two-thirds (64.2%) of patients with symptomatic treatment still reported moderate to severe pain.CONCLUSIONS: Myelitis episodes involving upper thoracic segments are main drivers of pain in NMOSD. Although pain intensity was lower than in previous studies, pain and depression remain undertreated and strongly affect QoL. Interventional studies on targeted treatment strategies for pain are urgently needed in NMOSD.
U2 - 10.1212/NXI.0000000000000985
DO - 10.1212/NXI.0000000000000985
M3 - SCORING: Journal article
C2 - 34108267
VL - 8
JO - NEUROL-NEUROIMMUNOL
JF - NEUROL-NEUROIMMUNOL
SN - 2332-7812
IS - 3
M1 - e985
ER -
