Pain in patients with neuromyelitis optica spectrum disorders
Bibliographic record
Abstract
Neuromyelitis optica spectrum disorders (NMOSD) are a group of chronic autoimmune diseases of the central nervous system with a relapsing course. Unfortunately, the symptoms of exacerbation cannot always be completely stopped, and in addition to motor disorders, chronic pain and depression can worsen the patient's condition. Currently, one of the factors that significantly affects the quality of life of patients in this group is chronic, debilitating pain. Objective: to determine the prevalence of the pain syndrome in the population of NMOSD patients in Moscow region, to investigate its clinical characteristics and its impact on quality of life. Material and methods. The study included 33 patients with NMOSD (6 men and 27 women) aged 22 to 64 years. The following criteria were used to assess the neurological condition, presence and severity of the pain syndrome: Expanded Disability Status Scale (EDSS), Diagnostic Neuropathic Pain Questionnaire (DN4), Pain Detect Questionnaire (PDQ), McGill Pain Questionnaire (MPQ), SF-36 Quality of Life Questionnaire, Beck Depression Inventory and MRI data. Results. Among the patients analysed, the pain syndrome occurred in 19 patients (57.6%): 4 patients with NMOSD without antibodies against aquaporin-4 (AQP4-) and 15 with antibodies against AQP4 (AQP4+). In this group, neuropathic pain was observed in 14 patients (11 – AQP4+ and three – AQP4-), pain due to spasticity in 6 patients (5 – AQP4+ and 1 – AQP4-), painful tonic spasms in 2 patients with AQP4+ and neuropathic itching – in 1 patient with AQP4-. According to the questionnaires of the seropositive patients, the median DN4 was 3 [2; 3] (here and below the data are given in Me format [25th; 75th percentile]), PDQ – 6 [5; 12], on the MPQ scale: pain rank index – 11 [9; 15], index of the number of selected symptoms – 3 [3; 4], pain intensity – 2 [1; 3]. The results for the physical and psychological health domains of the SF36 questionnaire were 35.9 [6.5; 36] and 50.5 [5; 51.5] respectively. Among AQP4+ patients, 7 out of 15 patients were diagnosed with depression; in the AQPpatients, only one man was diagnosed with depression. There was a statistically significant correlation between the age of the patients and pain level: neuropathic pain according to DN4 was more pronounced in younger patients (p=0.009), and neuropathic pain was significantly more severe in patients with an early onset of the disease (p=0.04). Conclusion. There is currently no clear approach for the treatment of pain in NMOSD. In the present small study, different causes of pain were identified, depending on the location and severity of the lesion, the age of the patient and the duration of the disease. The most important factor in the prevention and treatment of pain syndrome in NMOSD is probably adequate immunotherapy of the disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".