Pain and depression have a significant impact on quality of life (QoL) and activities of daily living (ADL) in patients with myelin oligodendrocyte glycoprotein antibody (MOG-ab) -associated disease (MOGAD), but pain and depression persist Patients inadequately controlled these patients according to study results published in the European Journal of Neurology.
This cross-sectional exploratory study included 43 patients with MOGAD from the registry of the Neuromyelitis Optica Study Group (NEMOS). The study’s researchers collected clinical, demographic, pain, depression, and health-related quality of life (HR quality of life) using questionnaires. They rated patients’ pain using the PainDetect questionnaire, the abbreviated form of the short pain inventory and the abbreviated form of the McGill pain questionnaire, while they rated depression using the Beck Depression Inventory II. The study’s researchers rated HR quality of life using the short-form 36 health survey.
The mean age of the patient population was 39.2 years and a small majority of patients were female (67.4%). A total of 22 patients reported MOGAD-related pain, including nociceptive (n = 11), certain neuropathic (n = 8), and possible neuropathic (n = 3) pain. 18 patients reported depression.
Neuropathic pain was associated with the highest pain intensity and impairment of ADL when compared to nociceptive pain. Neuropathic pain was more commonly described as shooting (P <0.001), sharp (P = 0.014), hot burning (P = 0.018), and anxious (P = 0.032). Certain neuropathic pain was also associated with significantly more restricted gait compared to nociceptive pain (P = 0.032).
A total of 15 patients reported spasticity-related pain, including 4 patients with short-term painful tonic spasms. Chronic pain was associated with a later onset of the disease (mean 37.6 vs. 29.3 years; P = 0.039), severe physical impairment (median self-reported gait function value 1 vs. 0; P = 0.005), and depression (59, 1% versus 25.0%; P = 0.034) in patients with MOGAD-related pain compared to patients without.
In addition, the prevalence of clinically relevant depression was higher in patients with pain than in patients without disease-related pain (59.1% versus 25%; P = 0.034). The only significant predictor of poor mental quality of life was clinically relevant depression (P <0.001). Predictors of physical quality of life were the severity of pain (P <0.001), visual function (P <0.001) and gait function (P = 0.005).
12 (54.5%) of the patients with MOGAD-related pain received pain medication, while 4 of 15 patients with spasticity-related pain received antispastic medication.
A limitation of this study was the reliance on data from a self-administered questionnaire, which led to a lack of clear diagnoses of specific pain syndromes.
The study’s researchers concluded that “Pain and depression have a profound impact on quality of life and ADL in MOGAD” and are widespread, but that additional “research is needed to examine precise underlying mechanisms and develop specific pain management strategies “.
Asseyer S., Henke E., Trebst C. et al. Pain, depression, and quality of life in adults with MOG antibody-associated diseases. Published online 10 January 2021. Eur J Neurol. doi: 10.1111 / ene.14729