title: Pain in patients with transverse myelitis and its relationship to aquaporin 4 antibody status.
abstract: Pain in transverse myelitis has been poorly studied. The aim of the study was to investigate the relationship between transverse myelitis related pain and disability, quality of life, anxiety and depression, cognitive-affective states in neuromyelitis optica (NMO) patients and aquaporin4 antibody status (AQP4-Ab +ve as positive and AQP4-Ab -ve as negative). Transverse myelitis patients (44 in total; 29 AQP4-Ab +ve and 15 AQP4-Ab -ve) completed questionnaires including Pain Severity Index (PSI), Pain Catastrophising Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 quality of life (SF-36 QOL). Clinical details such as disability, gender, age and spinal cord lesion type (short or long lesion) were noted. Correlation and multiple linear regression tests were performed using these clinical scores. Pain was found to be correlated strongly with quality of life in both groups but only correlated with disability in the AQP4-Ab +ve group. PCS, HADS and EDMUS were found to be highly correlated with pain severity using partial correlation, however, a stronger relationship between pain severity and PCS was found in the AQP4-Ab -ve group. Multiple regression analysis showed that pain severity was the most important factor for quality of life but not disability or anxiety and depression symptoms in the whole patient group. We confirm that pain is an important symptom of transverse myelitis and has more influence on quality of life than disability despite health services being predominantly focused on the latter. There may be different factors associated with pain between AQP4-Ab +ve and -ve patients.
authors.affiliation: Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Yazhuo
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Okoruwa
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Revis
authors.affiliation: Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: George
authors.initials: G
authors.lastname: Tackley
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Leite
authors.affiliation: Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Lee
authors.affiliation: Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Irene
authors.initials: I
authors.lastname: Tracey
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. Electronic address: jacqueline.palace@ndcn.ox.ac.uk.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Palace
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000276:immunology; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000378:metabolism*; D058443:Catastrophization / Q000276:immunology; D003863:Depression / Q000276:immunology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000150:complications / Q000276:immunology* / Q000523:psychology; D010146:Pain / Q000150:complications / Q000276:immunology* / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies
keywords: Aquaporin-4 antibodies; Neuromyelitis optica; Neuropathic pain; Quality of life; Transverse myelitis