Prevalence of spasticity and spasticity-related pain among patients with Amyotrophic Lateral Sclerosis

Verschueren, Annie; Grapperon, Aude-Marie; Delmont, Émilien; Attarian, Shahram

doi:10.1016/j.neurol.2020.08.009

Cited by 13 publications

(13 citation statements)

References 35 publications

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“…According to a recent study conducted in a tertiary hospital in France, the prevalence of spasticity was 36% in patients with ALS, and approximately half (42.5%) of those patients had mild pain. However, 16.7% of patients with spasticity had moderate to severe pain, with numeric rating scale scores of ≥4 [ 47 ].…”

Section: Characteristics Of Painmentioning

confidence: 99%

Pain in amyotrophic lateral sclerosis: a narrative review

Kwak

2022

J Yeungnam Med Sci

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Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

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Section: Characteristics Of Painmentioning

confidence: 99%

Pain in amyotrophic lateral sclerosis: a narrative review

Kwak

2022

J Yeungnam Med Sci

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“…Most of the remaining cases are bulbar-onset, which initially manifests with speech and swallowing problems. Most commonly, ALS starts at varying advanced age (up to 80 years), with a mean age of about 60 years at onset of sporadic disease (about 50 years in familial disease), shows progressive muscle weakness and atrophy leading to paralysis, loss of the dexterity, ability to move,, talk, eat, and breathe, is often accompanied by spasticity (Sect 3) and pain, and ends with death 3 to 5 years after disease onset (Chiò et al 2017;Delpont et al 2019;Kiernan et al 2011;Kiernan et al 2021;Riancho et al 2021;Verschueren et al 2021).…”

Section: Amyotrophic Lateral Sclerosis (Als)mentioning

confidence: 99%

“…Primary causes of pain include pain with neuropathic features, spasticity, and cramps, with the latter being the major cause, while spasticity typically starts at advanced stages. Secondary causes develop during progressive paresis, which induces immobility and degenerative changes in connective tissue, bones, and joints, leading to musculo-skeletal pain (Chiò et al 2017;Delpont et al 2019;Riancho et al 2021;Verschueren et al 2021). Rhythmic stimulation, treadmill training, and cycling enhance the expression of brain-derived neutrophic factor (BDNF) and counters the development of nociceptive sensitization (Grau et al 2020).…”

Section: Other Sensory Inputsmentioning

confidence: 99%

Plastic Spinal Motor Circuits in Health and Disease

Windhorst¹,

Dibaj²

2022

Preprint

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In former times, the spinal cord was considered a hard-wired network for spinal reflexes and a conduit for long-range connections. This view has changed dramatically over the past few decades. It is now recognized as a plastic device whose structures and functions adapt to changing circumstances. While such changes also occur under physiological conditions, the most dramatic alterations take place during or after various pathological events. It is astonishing what mechanisms the musculo-skeletal system has evolved to come to grips with the damages. Many of these changes are maladaptive, but some appear to help adapt to the new conditions. Although myriads of studies, using manifold methods, have been devoted to elucidating the underlying mechanisms, in humans and animal models, the etiology and pathophysiology of various diseases are still little understood, due to a number of reasons. We will here try to summarize some results and remaining problems in a selection of diseases, in particular spinal muscular atrophy (SMA), amyotrophic laterals sclerosis (ALS), and predominantly spinal cord injury (SCI) with occasional relations to stroke. Especially the changes in SCI (and stroke) depend on the cause, site and extent of the afflicted damage and are therefore multifarious. At the end, we will briefly summarize results indicating that operant, classical and instrumental conditioning can be used to produce plastic changes in healthy people, with potentials for applications to patients with spinal cord injury. In order not to overload the article, we will not delve deeply into sub-cellular processes.

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“…Pain is considered a common symptom in ALS, with frequencies varying from less than 15% to 85% ( Newrick and Langton-Hewer, 1985 ; Chiò et al, 2012 , 2017 ; Pagnini et al, 2012 ; Pizzimenti et al, 2013 ; Rivera et al, 2013 ; Wallace et al, 2014 ; Hanisch et al, 2015 ; Stephens et al, 2015 ; Moisset et al, 2016 ; Ishida et al, 2018 ; Lopes et al, 2018 ; Delpont et al, 2019 ; Gicalone et al, 2019 ; Taga et al, 2019 ; Åkerblom et al, 2020 ; Edge et al, 2020 ; Kong et al, 2021 ; Verschueren et al, 2021 ). Guidelines for ALS treatment reported that pain may be present in ALS patients and should be treated ( Miller et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Pain-Related Factors and Their Impact on Quality of Life in Chinese Patients With Amyotrophic Lateral Sclerosis

et al. 2022

Front. Neurosci.

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ObjectivesPain is considered a common symptom in amyotrophic lateral sclerosis (ALS). However, the results of studies on pain in ALS are limited and inconsistent. The aim of our study was to comprehensively evaluate the potential factors of pain and effects on quality of life (QoL) in patients with ALS from China.Participants and MethodsPatients were eligible if they fulfilled the criteria of probable and definitive ALS according to the revised El Escorial criteria. Pain was assessed by the Brief Pain Inventory (BPI). Disease severity, sleep quality, fatigue, anxiety, depression, and quality of life (QoL) were evaluated in ALS patients by the ALS Functional Rating Scale-revised (ALSFRS-R) and ALS severity scale (ALSSS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale (HDRS) and McGill Quality of Life Questionnaire (MQOL). Then, the clinical characteristics of ALS patients with pain were compared with those without pain. Last, associated factors of pain, as well as impact on QoL in Chinese ALS patients, were assessed.ResultsA total of 86 ALS patients were included. ALS patients with pain tended to have higher FSS scores and poorer QoL. The FSS score and ALSSS [lower extremity (LE) + upper extremity (UE)] were associated with pain in ALS patients. The ALS Functional Rating Scale-revised (ALSFRS-R), Pain Severity Index (PSI), HARS and HDRS scores were significantly associated with both the physical and psychological domains of QoL.ConclusionOur study was the first to comprehensively evaluate factors associated with pain in Chinese ALS patients, finding that fatigue can be a risk factor for pain and ALSSS (LE + UE) score was related with pain intensity. Additionally, we identified the adverse effects of ALSSS (LE + UE), HARS and HDRS scores on QoL in Chinese ALS patients.

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Prevalence of spasticity and spasticity-related pain among patients with Amyotrophic Lateral Sclerosis

Cited by 13 publications

References 35 publications

Pain in amyotrophic lateral sclerosis: a narrative review

Pain in amyotrophic lateral sclerosis: a narrative review

Plastic Spinal Motor Circuits in Health and Disease

Pain-Related Factors and Their Impact on Quality of Life in Chinese Patients With Amyotrophic Lateral Sclerosis

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