title: Increased multiple sclerosis relapses related to lower prevalence of pain.
abstract: OBJECTIVE
  The study aims to investigate the presence of pain amongst multiple sclerosis (MS) patients.
  
  
  METHODS
  One hundred MS patients responded to questionnaires evaluating neuropathic and nociceptive pain, depression and anxiety. Statistical analysis was performed using the Mann-Whitney U, Chi-Square and two-tailed Fisher's exact tests and multivariate logistic regression.
  
  
  RESULTS
  Women had a statistically higher prevalence of pain (p = 0.037), and chances of having pain after the age of 50 reduced. Women with pain had a statistically significant lower number of relapses (p = 0.003), restricting analysis to those patients with more than one relapse. After the second relapse, each relapse reduced the chance of having pain by 46%. Presence of pain was independent of Expanded Disability Status Scale (EDSS) anxiety, and depression.
  
  
  CONCLUSIONS
  Our findings suggest a strong inverse association between relapses and pain indicating a possible protective role of focal inflammation in the control of pain.
authors.affiliation: Centro de Pesquisas Clínicas em Neurologia/Neurociência, Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: José Vinícius Martins da
authors.initials: JV
authors.lastname: Silva
authors.affiliation: Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Beatriz Fátima Alves de
authors.initials: BF
authors.lastname: Oliveira
authors.affiliation: Centro de Pesquisas Clínicas em Neurologia/Neurociência, Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: Osvaldo José Moreira do
authors.initials: OJ
authors.lastname: Nascimento
authors.affiliation: Centro de Pesquisas Clínicas em Neurologia/Neurociência, Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: João Gabriel Dib
authors.initials: JG
authors.lastname: Farinhas
authors.affiliation: Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: Maria Graziella
authors.initials: MG
authors.lastname: Cavaliere
authors.affiliation: Centro de Pesquisas Clínicas em Neurologia/Neurociência, Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: Henrique de Sá Rodrigues
authors.initials: Hde S
authors.lastname: Cal
authors.affiliation: Centro de Pesquisas Clínicas em Neurologia/Neurociência, Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
authors.forename: André Palma da Cunha
authors.initials: AP
authors.lastname: Matta
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D001007:Anxiety / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology; D009437:Neuralgia / Q000453:epidemiology* / Q000503:physiopathology; D059226:Nociceptive Pain / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D012008:Recurrence; D017678:Sex Distribution; D012737:Sex Factors