title: Clinical characteristics of pain in patients with pituitary adenomas.
abstract: OBJECTIVE
  Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease.
  
  
  METHODS
  In a cross-sectional study, we assessed 278 patients with pituitary disease (n=81 acromegaly; n=45 Cushing's disease; n=92 prolactinoma; n=60 non-functioning pituitary adenoma).
  
  
  METHODS
  Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL).
  
  
  RESULTS
  We recorded a high prevalence of bodily pain (n=180, 65%) and headache (n=178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (n=34, 76%). Headache was equally frequent in patients with macro- and microadenomas (68 vs 60%; P=0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (n=193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL.
  
  
  CONCLUSIONS
  Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL.
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Dimopoulou
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: A P
authors.initials: AP
authors.lastname: Athanasoulia
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Hanisch
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Held
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Sprenger
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: T R
authors.initials: TR
authors.lastname: Toelle
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Roemmler-Zehrer
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Schopohl
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland.
authors.forename: G K
authors.initials: GK
authors.lastname: Stalla
authors.affiliation: Department of EndocrinologyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyDepartment of NeurologyTechnische Universität München, Munich, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-University, Munich, GermanyDepartment of NeurologyUniversity Hospital Basel, Basel, SwitzerlandDivision of NeuroradiologyDepartment of Radiology, University Hospital Basel, Basel, Switzerland csievers@mpipsykl.mpg.de.
authors.forename: C
authors.initials: C
authors.lastname: Sievers
mesh_terms: D000236:Adenoma / Q000150:complications / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology; D059226:Nociceptive Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement; D010911:Pituitary Neoplasms / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires