Severe MS Associated With Increased Neuropathic Pain Risk

Neuropathic pain is associated with a more severe multiple sclerosis disease phenotype.

More severe cases of multiple sclerosis (MS) are linked with a greater likelihood of developing neuropathic pain, based on a study published in the Journal of Neurology.

This multicenter, cross-sectional study involved 1249 subjects with a mean age of 33.9 years, 832 of whom were female and 417 of whom were male. The group had a mean disease duration of 8 years and a mean Expanded Disability Status Scale (EDSS) score of 3.2.

Researchers distinguished neuropathic from nociceptive pain using the DN4 questionnaire and clinical evaluation and used the Neuropathic Pain Symptom Inventory to further distinguish symptoms of neuropathic pain.

Researchers classified 429 patients (34.34%) as having pain, out of whom 3 were excluded after collecting insufficient data. There were 470 syndromes consisting of 184 neuropathic and 286 nociceptive pain syndromes.

After multivariate analyses, researchers found that pain correlated with gender, disease severity, and age, and that neuropathic pain displayed a clear link with EDSS score.

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Because pain is a frequent problem with MS, with a prevalence between 40% and 86%, a detailed study was needed to quantify and differentiate between its various categories.

This research “shows that a more severe disease course is associated with a higher risk of neuropathic pain. Our findings might, therefore, provide a basis for improving the clinical management of this common MS complication.”


Solaro C, Cella M, Signori A, et al; on behalf of the Neuropathic Pain Special Interest Group of the Italian Neurological Society. Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria [published online February 5, 2018]. J Neurol. doi:10.1007/s00415-018-8758-2