Pain in AQP4-IgG-positive and MOG-IgG-positive neuromyelitis optica spectrum disorders - Susanna Asseyer, Felix Schmidt, Claudia Chien, Michael Scheel, Klemens Ruprecht, Judith Bellmann-Strobl, Alexander U Brandt, Friedemann Paul, 2018

Pain in AQP4-IgG-positive and MOG-IgG-positive neuromyelitis optica spectrum disorders - Susanna Asseyer, Felix Schmidt, Claudia Chien, Michael Scheel, Klemens Ruprecht, Judith Bellmann-Strobl, Alexander U Brandt, Friedemann Paul, 2018

Pain in AQP4-IgG-positive and MOG-IgG-positive neuromyelitis optica spectrum disorders

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Susanna Asseyer, Felix Schmidt, Claudia Chien, ...

First Published August 30, 2018 Research Article 

https://doi.org/10.1177/2055217318796684

Article information

  

Abstract

Background

Pain is a frequent symptom in aquaporin-4-immunoglobulin-G-positive neuromyelitis optica spectrum disorders (AQP4-IgG-pos. NMOSD). Data on pain in myelin-oligodendrocyte-glycoprotein-immunoglobulin-G autoimmunity with a clinical NMOSD phenotype (MOG-IgG-pos. NMOSD) are scarce.

Objective

The objective of this paper is to investigate pain in MOG-IgG-pos. NMOSD, AQP4-IgG-pos. NMOSD and NMOSD without AQP4/MOG-IgG detection (AQP4/MOG-IgG-neg. NMOSD).

Methods

Forty-nine MOG-IgG-pos. (n = 14), AQP4-IgG-pos. (n = 29) and AQP4/MOG-IgG-neg. (n = 6) NMOSD patients were included in this cross-sectional baseline analysis from an ongoing observational study. We identified spinal cord lesions on magnetic resonance imaging, assessed pain by the painDETECT and McGill Pain questionnaires, quality of life by Short Form Health Survey, and depression by Beck Depression Inventory.

Results

Twelve MOG-IgG-pos. NMOSD patients (86%), 24 AQP4-IgG-pos. NMOSD patients (83%), and all AQP4/MOG-IgG-neg. NMOSD patients (100%) suffered from pain. MOG-IgG-pos. NMOSD patients had mostly neuropathic pain and headache; AQP4-IgG-pos. and AQP4/MOG-IgG-neg. NMOSD patients had mostly neuropathic pain. A history of myelitis was less frequent in MOG-IgG-pos. NMOSD than in AQP4-IgG-pos. NMOSD patients. Pain influenced quality of life in all patients. Thirty-six percent of patients with pain received pain medication; none of them were free of pain.

Conclusions

Pain is a frequent symptom of patients with MOG-IgG-pos. NMOSD and is as important as in AQP4-IgG-pos. and AQP4/MOG-IgG-neg. NMOSD. Despite its impact on quality of life, pain is insufficiently alleviated by medication.

Keywords Aquaporin 4 (AQP4), myelin oligodendrocyte glycoprotein antibody (MOG), neuromyelitis optica (NMO) spectrum disease (NMOSD), pain