Sensory Function and Chronic Pain in Multiple Sclerosis

Abstract

Objective To examine whether hypoesthesia and chronic pain are related in patients with MS. Methods Sixty-seven MS patients with pain and 80 persons without MS were included. Sensory functioning was tested by bedside neurological examination. Touch, joint position (dorsal column-medial lemniscus pathway), temperature sense, and pain (spinothalamic tract) were tested. Pain intensity was measured by the Colored Analogue Scale (CAS Intensity) and the Faces Pain Scale (FPS); pain affect was also measured by CAS Affect and Number of Words Chosen-Affective (NWC-A). Mood was assessed with the SCL-90 anxiety and depression subscales and the Beck Depression Inventory (BDI). Results A significant negative relationship was found between pain intensity and the function of the dorsal column-medial lemniscal pathway, but not with the spinothalamic tract. Conclusion In addition to the already known relation between hyperesthesia and pain, hypoesthesia for touch and joint position also seems to be related to chronic pain in MS patients.

Characterizing chronic pain phenotypes in multiple sclerosis: a nationwide survey study

“…Nociceptive pain has been recognized as 1 pain subtype in MS, often associated with postural problems, deconditioning, and/or muscle spasms. 51 , 56 However, the prominent focus on neuropathic pain in MS has contributed to lack of understanding of the scope and nature of nociceptive pain in MS. Given the relatively high prevalence of nociceptive pain in our sample (41%; indicated by neither neuropathic nor nociplastic pain characteristics), it is critical to gain a better understanding of nociceptive pain with an eye toward optimizing treatment for this pain subtype.…”

“… 47 , 56 Higher use of cannabinoids in those with nociplastic pain either alone or along with neuropathic pain (mixed pain) is consistent with previous findings that people with MS who demonstrated sensory disturbances indicative of pain centralization reported higher use of cannabis. 51 Although these initial findings indicate that medications may have different analgesic effects based on pain phenotype, the ability to predict treatment response from survey scores needs to be tested in MS.…”

Clinical predictors of driving simulator performance in drivers with multiple sclerosis

“…Sensory impairment is prevalent in up to 90% of individuals with MS (Scherder et al, 2018;Svendsen et al, 2005;Uszynski et al, 2016). Individuals may experience paresthesia (e.g., prickling sensation, tingling, painful burning), hypesthesia (e.g., reduced sensation, numbness), neuropathic pain, and losses in proprioception, which may impact their physical ability to operate a motor vehicle (Scherder et al, 2018;Svendsen et al, 2005;Uszynski et al, 2016).…”

Clinical perspective on pain in multiple sclerosis

“…4,25 In addition, Scherder and colleagues found that 24% of pwMS with chronic pain had decreased touch sensibility and 26% of pwMS had decreased joint position sense indicating dorsal column-medial lemniscal pathway dysfunctioning. 26 However, they excluded participants with central pain.…”