Pain in patients with multiple sclerosis: a complex assessment including quantitative and qualitative measurements provides for a disease-related biopsychosocial pain model.
Pain in patients with multiple sclerosis: a complex assessment including quantitative and qualitative measurements provides for a disease-related biopsychosocial pain model.
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DOI：
10.2147/jpr.s20309
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发表时间：
2011
影响因子：
2.7
通讯作者：
Bergh FT
中科院分区：
文献类型：
--
作者：
Michalski D;Liebig S;Thomae E;Hinz A;Bergh FT
各种原因引起的疼痛是多发性硬化(MS)患者的常见现象。生物-心理-社会视角已被证明是其他慢性疼痛条件下的一个有用的理论构思，也开始于多发性硬化症。为了支持这种方法，我们的目标是研究多发性硬化症的疼痛，特别强调分离定量和定性方面，以及它与行为和生理方面的相互关系。对38例门诊MS患者(平均年龄42.0±11.5岁，女性占82%)进行疼痛强度(NRS)和疼痛质量(SES)测定。疼痛相关行为(FSR)、卫生保健利用、躯体抱怨(GBB-24)和疲劳(WEIMuS)通过问卷调查进行评估，MS相关神经功能障碍通过标准化神经检查(EDSS)进行评估。在整个样本中，平均疼痛强度为4.0(范围0-10)，平均EDSS为3.7(范围0-8)。目前，81.6%的患者报告了目前存在的疼痛。病程和EDSS在有无疼痛的患者之间没有差别，也与疼痛的性质或强度无关。疼痛患者的肌肉骨骼主诉得分显著较高，但疲惫、胃肠道和心血管主诉的得分相同。疼痛强度只与身体方面相关，而疼痛质量还与更多的回避、听天由命和认知疲劳有关。与其他情况一样，多发性硬化症的疼痛必须以多维的方式进行评估。应该致力于进一步的研究，使现有的模型适应多发性硬化症特有的疼痛模型。
Pain of various causes is a common phenomenon in patients with Multiple Sclerosis (MS). A biopsychosocial perspective has proven a useful theoretical construct in other chronic pain conditions and was also started in MS. To support such an approach, we aimed to investigate pain in MS with special emphasis on separating quantitative and qualitative aspects, and its interrelation to behavioral and physical aspects. Pain intensity (NRS) and quality (SES) were measured in 38 consecutive outpatients with MS (mean age, 42.0 ± 11.5 years, 82% women). Pain-related behavior (FSR), health care utilization, bodily complaints (GBB-24) and fatigue (WEIMuS) were assessed by questionnaires, and MS-related neurological impairment by a standardized neurological examination (EDSS). Mean pain intensity was 4.0 (range, 0–10) and mean EDSS 3.7 (range, 0–8) in the overall sample. Currently present pain was reported by 81.6% of all patients. Disease duration and EDSS did not differ between patients with and without pain and were not correlated to quality or intensity of pain. Patients with pain had significantly higher scores of musculoskeletal complaints, but equal scores of exhaustion, gastrointestinal and cardiovascular complaints. Pain intensity correlated only with physical aspects, whereas quality of pain was additionally associated with increased avoidance, resignation and cognitive fatigue. As in other conditions, pain in MS must be assessed in a multidimensional way. Further research should be devoted to adapt existing models to a MS-specific model of pain.