PMID- 24525905
OWN - NLM
STAT- MEDLINE
DCOM- 20150819
LR  - 20141206
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 31
IP  - 1
DP  - 2015 Jan
TI  - Widespread pressure pain hypersensitivity in patients with multiple sclerosis 
      with and without pain as sign of central sensitization.
PG  - 66-72
LID - 10.1097/AJP.0000000000000084 [doi]
AB  - OBJECTIVE: To determine the presence of widespread pressure hyperalgesia in 
      multiple sclerosis (MS) patients with and without pain and its association with 
      pain and fatigue. METHODS: A total of 108 individuals with definite MS, 49 men 
      and 59 women (mean age, 44+/-8 y) and 108 age-matched and sex-matched pain-free 
      controls (mean age, 44+/-9 y) were included. Fifty patients (n=58, 54%) reported 
      pain and 50 (46%) did not. Pressure pain threshold (PPT) was bilaterally assessed 
      over supraorbital, infraorbital, mental, median, radial and ulnar nerve trunks, 
      C5-C6 joint, second metacarpal, and tibialis anterior muscle by an assessor 
      blinded to the patient's condition. The intensity of pain was assessed with a 
      numerical pain rate scale (0 to 10), fatigue was determined with the Fatigue 
      Impact Scale, and depression was evaluated with the Beck Depression Inventory. 
      RESULTS: The analyses of covariance revealed that PPT were significantly 
      decreased bilaterally over the supraorbital, infraorbital, mental, median, ulnar 
      and radial nerve trunks, C5-C6 joint, second metacarpal, and tibialis anterior 
      muscles in patients with MS compared with pain-free controls (all, P<0.001). No 
      significant differences existed between MS patients with pain and those without 
      pain (all P>0.944). Patients with pain exhibited higher fatigue and depression 
      than those patients without pain (P<0.05). PPT was not associated with any 
      clinical variable, that is, pain, depression, or fatigue. CONCLUSIONS: Our study 
      found widespread pressure pain hyperalgesia in individuals with MS as compared 
      with pain-free controls. No differences existed between MS patients with pain and 
      those without pain in the presence of widespread pressure sensitivity. Current 
      results suggest that MS is associated with sensory hyperexcitability of the 
      central nervous system or dysfunction in endogenous pain modulatory systems.
FAU - Fernandez-de-Las-Penas, Cesar
AU  - Fernandez-de-Las-Penas C
AD  - *Department of Physical Therapy, Occupational Therapy, Rehabilitation and 
      Physical Medicine, Universidad Rey Juan Carlos, Alcorcon  section signDepartment of Physical 
      Therapy, Universidad Antonio de Nebrija daggerLaboratory of Esthesiology, Facultad de 
      Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcon, Madrid  parallelDepartment 
      of Neurology, Hospital Nuestra Senora de Sonsoles, Avila, Spain double daggerDepartment of 
      Health Science and Technology, Centre for Sensory-Motor Interaction (SMI), 
      Aalborg University, Aalborg, Denmark.
FAU - Ortega-Santiago, Ricardo
AU  - Ortega-Santiago R
FAU - Ortiz-Gutierrez, Rosa
AU  - Ortiz-Gutierrez R
FAU - Caminero, Ana B
AU  - Caminero AB
FAU - Salom-Moreno, Jaime
AU  - Salom-Moreno J
FAU - Arendt-Nielsen, Lars
AU  - Arendt-Nielsen L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
SB  - IM
MH  - Adult
MH  - Analysis of Variance
MH  - Case-Control Studies
MH  - Depression/diagnosis/*etiology
MH  - Female
MH  - Humans
MH  - Hyperalgesia/*etiology
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*complications
MH  - Pain/*complications
MH  - Pain Measurement
MH  - Pain Threshold/*physiology
MH  - Pressure/*adverse effects
MH  - Psychiatric Status Rating Scales
MH  - Sample Size
EDAT- 2014/02/15 06:00
MHDA- 2015/08/20 06:00
CRDT- 2014/02/15 06:00
PHST- 2014/02/15 06:00 [entrez]
PHST- 2014/02/15 06:00 [pubmed]
PHST- 2015/08/20 06:00 [medline]
AID - 10.1097/AJP.0000000000000084 [doi]
PST - ppublish
SO  - Clin J Pain. 2015 Jan;31(1):66-72. doi: 10.1097/AJP.0000000000000084.