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In MS, Patients With Central Neuropathic Pain Carry Highest Emotional Burden
Emotional burden and pain severity were greater in patients with multiple sclerosis (MS) who had central neuropathic pain than those who had musculoskeletal pain, according to study results published in the Journal of Neurology.
The study looked at emotional burden by chronic pain diagnosis, or lack thereof, in 125 patients with MS. Among them, 55 had central neuropathic pain, 30 had musculoskeletal pain, and 40 were pain-free. The investigation also included 30 healthy controls. Participants answered questions that assessed for pain interference, pain catastrophizing, depression, anxiety, stress, hypervigilance, and chronic pain.
Compared with patients with musculoskeletal pain, patients with central neuropathic pain had more widespread chronic pain, according to the study. Both groups of patients with pain had higher pain interference, pain catastrophizing, and stress than patients who were pain-free and healthy controls.
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Depression levels were higher in all MS groups compared with healthy controls, while anxiety levels were highest in patients with central neuropathic pain, the study found.
Cluster analysis showed patients with central neuropathic pain made up 57% of the “high psychological distress” cluster. The “minimal psychological distress” cluster, meanwhile, comprised mainly patients with MS who were pain-free and healthy controls.
“Whereas depression may be attributed to MS, and anxiety to central neuropathic pain, enhanced pain interference, catastrophizing, and stress may be attributed to the comorbidity of MS and chronic pain,” wrote corresponding author Ruth Defrin, PhD, and study coauthors. “Identifying these traits among MS patients and targeting them in management programs may contribute to more effective, individually based care.”
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