Prevalence of Pain within Limb Girdle Muscular Dystrophy R9 and Implications for Other Degenerative Diseases

Mark Richardson, Anna Mayhew, Robert Muni-Lofra, Lindsay B Murphy, Volker Straub, Mark Richardson, Anna Mayhew, Robert Muni-Lofra, Lindsay B Murphy, Volker Straub

Abstract

Our primary aim was to establish the prevalence of pain within limb girdle muscular dystrophy R9 (LGMDR9). As part of the Global FKRP Registry, patients are asked to complete the Short Form McGill Pain Questionnaire (SF-MPQ) annually. We used the results of this questionnaire to determine individuals' maximum pain score and total pain score and examined overall pain intensity and associations between pain intensity and LGMDR9 genotypes, age, and ambulatory status. We also considered the pain descriptors used and pain progression over time. Of the 502 patients, 87% reported current pain and 25% reported severe current pain. We found no associations in pain severity between the different genotypes of LGMDR9. However, we did find statistically significant associations between pain severity and ambulatory status and between our paediatric and adult populations. We found pain descriptors to be more common words that one may associate with non-neural pain, and we found that a significant number of individuals (69%) reported a fluctuating pain pattern over time. We concluded that pain should be considered a significant issue among individuals with LGMDR9 requiring management. Implications regarding assessment of pain for other degenerative diseases are discussed.

Keywords: LGMDR9; limb girdle muscular dystrophy; neuromuscular diseases; pain; pain assessment; pain management.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Severity of pain by LGMDR9 type.
Figure 2
Figure 2
Severity of pain by age; paediatric versus adult.
Figure 3
Figure 3
Severity of pain by ambulatory status.
Figure 4
Figure 4
Percentage of individuals reporting each pain descriptor.

References

    1. De Visser M., Oliver D.J. Palliative Care in Neuromuscular Diseases. Curr. Opin. Neurol. 2017;30:686–691. doi: 10.1097/WCO.0000000000000493.
    1. Carter G.T., Jensen M.P., Galer B.S., Kraft G.H., Crabtree L.D., Beardsley R.M., Abresch R.T., Bird T.D. Neuropathic Pain in Charcot-Marie-Tooth Disease. Arch. Phys. Med. Rehabil. 1998;79:1560–1564. doi: 10.1016/S0003-9993(98)90421-X.
    1. Zebracki K., Drotar D. Pain and Activity Limitations in Children with Duchenne or Becker Muscular Dystrophy. Dev. Med. Child Neurol. 2008;50:546–552. doi: 10.1111/j.1469-8749.2008.03005.x.
    1. Tiffreau V., Viet G., Thévenon A. Pain and Neuromuscular Disease: The Results of a Survey. Am. J. Phys. Med. Rehabil. 2006;85:756–766. doi: 10.1097/01.phm.0000228518.26673.23.
    1. Abresch R.T., Carter G.T., Jensen M.P., Kilmer D.D. Assessment of Pain and Health-Related Quality of Life in Slowly Progressive Neuromuscular Disease. Am. J. Hosp. Palliat. Med. 2016;19:39–48. doi: 10.1177/104990910201900109.
    1. Engel J.M., Kartin D., Jaffe K.M. Exploring Chronic Pain in Youths with Duchenne Muscular Dystrophy: A Model for Pediatric Neuromuscular Disease. Phys. Med. Rehabil. Clin. 2005;16:1113–1124. doi: 10.1016/j.pmr.2005.08.003.
    1. Lager C., Kroksmark A.K. Pain in Adolescents with Spinal Muscular Atrophy and Duchenne and Becker Muscular Dystrophy. Eur. J. Paediatr. Neurol. 2015;19:537–546. doi: 10.1016/j.ejpn.2015.04.005.
    1. Jacques M.F., Stockley R.C., Bostock E.I., Smith J., DeGoede C.G., Morse C.I. Frequency of Reported Pain in Adult Males with Muscular Dystrophy. PLoS ONE. 2019;14:e0212437. doi: 10.1371/journal.pone.0212437.
    1. Hoffman A.J., Jensen M.P., Abresch R.T., Carter G.T. Chronic Pain in Persons with Neuromuscular Disease. Phys. Med. Rehabil. Clin. 2005;16:1099–1112. doi: 10.1016/j.pmr.2005.08.015.
    1. Miró J., Gertz K.J., Carter G.T., Jensen M.P. Pain Location and Intensity Impacts Function in Persons with Myotonic Dystrophy Type 1 and Facioscapulohumeral Dystrophy with Chronic Pain. Muscle Nerve. 2014;49:900–905. doi: 10.1002/mus.24079.
    1. Bushby K.M.D., Pollitt C., Johnson M.A., Rogers M.T., Chinnery P.F. Muscle Pain as a Prominent Feature of Facioscapulohumeral Muscular Dystrophy (FSHD): Four Illustrative Case Reports. Neuromuscul. Disord. 1998;8:574–579. doi: 10.1016/S0960-8966(98)00088-1.
    1. Van der Kooi E.L., Kalkman J.S., Lindeman E., Hendriks J.C.M., van Engelen B.G.M., Bleijenberg G., Padberg G.W. Effects of Training and Albuterol on Pain and Fatigue in Facioscapulohumeral Muscular Dystrophy. J. Neurol. 2007;254:931–940. doi: 10.1007/s00415-006-0432-4.
    1. Pangalila R.F., van den Bos G.A., Bartels B., Bergen M., Stam H.J., Roebroeck M.E. Prevalence of Fatigue, Pain, and Affective Disorders in Adults With Duchenne Muscular Dystrophy and Their Associations With Quality of Life. Arch. Phys. Med. Rehabil. 2015;96:1242–1247. doi: 10.1016/j.apmr.2015.02.012.
    1. Richardson M., Frank A.O. Electric Powered Wheelchairs for Those with Muscular Dystrophy: Problems of Posture, Pain and Deformity. Disabil. Rehabil. Assist. Technol. 2009;4:181–188. doi: 10.1080/17483100802543114.
    1. Peric M., Peric S., Rapajic N., Dobricic V., Savic-Pavicevic D., Nesic I., Radojicic S., Novakovic I., Lavrnic D., Rakocevic-Stojanovic V. Multidimensional Aspects of Pain in Myotonic Dystrophies. Acta Myol. 2015;34:126.
    1. De Groot I.J., Voet N.B., van Middendorp H., Knoop H.A., Rahbek J., van Engelen B.G. 184th ENMC International Workshop: Pain and Fatigue in Neuromuscular Disorders: 20–22 May 2011, Naarden, The Netherlands. Neuromuscul. Disord. 2013;23:1028–1032. doi: 10.1016/j.nmd.2013.06.370.
    1. Della Marca G., Frusciante R., Vollono C., Iannaccone E., Dittoni S., Losurdo A., Testani E., Gnoni V., Colicchio S., di Blasi C., et al. Pain and the Alpha-Sleep Anomaly: A Mechanism of Sleep Disruption in Facioscapulohumeral Muscular Dystrophy. Pain Med. 2013;14:487–497. doi: 10.1111/pme.12054.
    1. Padua L., Aprile I., Frusciante R., Iannaccone E., Rossi M., Renna R., Messina S., Frasca G., Ricci E. Quality of Life and Pain in Patients with Facioscapulohumeral Muscular Dystrophy. Muscle Nerve. 2009;40:200–205. doi: 10.1002/mus.21308.
    1. Morís G., Wood L., FernáNdez-Torrón R., González Coraspe J.A., Turner C., Hilton-Jones D., Norwood F., Willis T., Parton M., Rogers M., et al. Chronic Pain Has a Strong Impact on Quality of Life in Facioscapulohumeral Muscular Dystrophy. Muscle Nerve. 2018;57:380–387. doi: 10.1002/mus.25991.
    1. Jensen M.P., Hoffman A.J., Stoelb B.L., Abresch R.T., Carter G.T., McDonald C.M. Chronic Pain in Persons With Myotonic Dystrophy and Facioscapulohumeral Dystrophy. Arch. Phys. Med. Rehabil. 2008;89:320–328. doi: 10.1016/j.apmr.2007.08.153.
    1. Guy-Coichard C., Nguyen D.T., Delorme T., Boureau F. Pain in Hereditary Neuromuscular Disorders and Myasthenia Gravis: A National Survey of Frequency, Characteristics, and Impact. J. Pain Symptom. Manag. 2008;35:40–50. doi: 10.1016/j.jpainsymman.2007.02.041.
    1. Jensen M.P., Abresch R.T., Carter G.T., McDonald C.M. Chronic Pain in Persons with Neuromuscular Disease. Arch. Phys. Med. Rehabil. 2005;86:1155–1163. doi: 10.1016/j.apmr.2004.11.028.
    1. Engel J.M., Kartin D., Carter G.T., Jensen M.P., Jaffe K.M. Pain in Youths With Neuromuscular Disease. Am. J. Hosp. Palliat. Care. 2009;26:405. doi: 10.1177/1049909109346165.
    1. Thompson R., Straub V. Limb-Girdle Muscular Dystrophies—International Collaborations for Translational Research. Nat. Rev. Neurol. 2016;12:294–309. doi: 10.1038/nrneurol.2016.35.
    1. Fayaz A., Croft P., Langford R.M., Donaldson L.J., Jones G.T. Prevalence of Chronic Pain in the UK: A Systematic Review and Meta-Analysis of Population Studies. BMJ Open. 2016;6:10364. doi: 10.1136/bmjopen-2015-010364.
    1. Straub V., Murphy A., Udd B. Neuromuscular Disorders. Volume 28. Elsevier Ltd.; Amsterdam, The Netherlands: 2018. 229th ENMC International Workshop: Limb Girdle Muscular Dystrophies—Nomenclature and Reformed Classification Naarden, the Netherlands, 17–19 March 2017; pp. 702–710.
    1. Brockington M., Yuva Y., Prandini P., Brown S.C., Torelli S., Benson M.A., Herrmann R., Anderson L.V.B., Bashir R., Burgunder J.-M., et al. Mutations in the Fukutin-Related Protein Gene (FKRP) Identify Limb Girdle Muscular Dystrophy 2I as a Milder Allelic Variant of Congenital Muscular Dystrophy MDC1C. Hum. Mol. Genet. 2001;10:2851–2859. doi: 10.1093/hmg/10.25.2851.
    1. Frosk P., Greenberg C.R., Tennese A.A.P., Lamont R., Nylen E., Hirst C., Frappier D., Roslin N.M., Zaik M., Bushby K., et al. The Most Common Mutation in FKRP Causing Limb Girdle Muscular Dystrophy Type 21 (LGMD2I) May Have Occurred Only Once and Is Present in Hutterites and Other Populations. Hum. Mutat. 2005;25:38–44. doi: 10.1002/humu.20110.
    1. Murphy L.B., Schreiber-Katz O., Rafferty K., Robertson A., Topf A., Willis T.A., Heidemann M., Thiele S., Bindoff L., Laurent J., et al. Global FKRP Registry: Observations in More than 300 Patients with Limb Girdle Muscular Dystrophy R9. Ann. Clin. Transl. Neurol. 2020;7:757. doi: 10.1002/acn3.51042.
    1. Murphy A.P., Morrow J., Dahlqvist J.R., Stojkovic T., Willis T.A., Sinclair C.D.J., Wastling S., Yousry T., Hanna M.S., James M.K., et al. Natural History of Limb Girdle Muscular Dystrophy R9 over 6 Years: Searching for Trial Endpoints. Ann. Clin. Transl. Neurol. 2019;6:1033–1045. doi: 10.1002/acn3.774.
    1. Willis T.A., Hollingsworth K.G., Coombs A., Sveen M.-L., Andersen S., Stojkovic T., Eagle M., Mayhew A., de Sousa P.L., Dewar L., et al. Quantitative Muscle MRI as an Assessment Tool for Monitoring Disease Progression in LGMD2I: A Multicentre Longitudinal Study. PLoS ONE. 2013;8:e70993. doi: 10.1371/journal.pone.0070993.

Source: PubMed

3
구독하다