SX09
Gender Differences in MS Related Pain, Correlation with Burden of Disease

Friday, May 29, 2015
Griffin Hall
Mirla Avila, MD , Neurology, Texas Tech University Health Sciences Center, Lubbock, TX
Volker Neugebauer, MD, PHD , Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX
John DeToledo, MD , Neurology, Texas Tech, Lubbock, TX



Background:

MS is a demyelinating disorder characterized by inflammation of the central nervous system. More predominant in woman.  Pain in MS occurs in 29% to 86% , management may be challenging. Central pain is estimated to occur in 17% to 52% of patients with MS. MS pain may present as burning, aching, pricking, stabbing, or squeezing. Painful extremity spasms are also classed as central pain. About 32% of MS patients complain of pain among their most severe symptoms. Severe pain invariably interferes with the quality of life in MS patients, since it becomes a frequent, disabling and incompletely controlled symptom.   There is preliminary evidence that the progression of pain symptoms to the state of chronic severe pain is the result of neurochemical and functional changes in the central nervous system. Studies of patients with chronic pain syndromes (non-MS patients), utilizing structural MRI and magnetic resonance spectroscopy (MRS) reveal abnormalities in brain regions involved in pain processing, including the thalamus, amygdala, prefrontal cortex, cingulate, and somatosensory cortex.

Previous studies have shown gender differences in the prevalence of chronic pain only for selected pain conditions.  Although MS is more common in women and pain is a common and disabling symptom in these patients, no studies have looked at whether the incidence, clinical features and severity of pain are different in women versus men with MS.

Objectives:

Evaluate possible gender differences in MS related pain . To assess for any relation with MS related pain and the burden of disease (number and localization of T2 white matter lesions in brain MRI and the presence of spinal cord involvement)

Methods:

This is an ongoing questionnaire based prospective study. Estimated number of 80 to 100 MS patients. The modified McGill questionnaire will be used for the patient to self-rate pain severity.

Demographic information obtained from medical records. Presence of neuropathic pain, somatic or visceral pain, and different qualitative and quantitative aspects of pain documented. Brain MRI will be evaluated for the presence of and number of hyperintense lesions in T2 and presence or absence of spinal cord involvement. MRI scans performed on a 1.5 Tesla MRI scanner. FLAIR and T2-weighted images will be evaluated for the presence of lesions, in particular for lesions in thalamus, amygdala, prefrontal cortex, cingulate, and somatosensory cortex.

Results:

This is an ongoing study, results are pending.

Conclusions:

In this present study we will evaluate the possible gender differences in MS-related pain and will evaluate if there is any relation with MS related pain and the burden of disease.