Highlights
- •Pain is a frequent symptom in patients with myotonic dystrophy type 2 (DM2) instead of pain is a frequent and important symptom in patients with myotonic dystrophy type 2.
- •Pain affects quality of life in patients with DM2.
- •Mechanical hyperalgesia is present in patients with DM2.
- •A peripheral mechanism of pain is likely to be present in DM2.
- •Central sensitization is at least less pronounced in DM2 than in fibromyalgia.
Abstract
Pain is a common but often ignored symptom in patients with myotonic dystrophy type
2 (DM2). In this explorative study, we assessed qualitative and quantitative aspects
of pain in DM2 using 4 questionnaires and quantitative sensory testing. A disease
control group (fibromyalgia [FMS]) as well as healthy controls were used to compare
the results, because pain in DM2 shows many clinical similarities to pain in FMS.
Thirty-four patients with genetically confirmed DM2 (71% female, mean age 54 years),
28 patients with FMS, and 33 healthy controls were included, age- as well as sex-matched.
Pain prevalence was 65% in DM2, 100% in FMS (P < .001), and 15% in healthy controls (P < .001). The mean of the pressure pain thresholds was lower in DM2 than in healthy
controls (P = .016), with the largest differences in the rectus femoris, trapezius, and thenar
muscles. Mechanical and electric pain thresholds were significantly higher in DM2
than in FMS, and no differences were found in electric pain thresholds between DM2
and healthy controls. These results confirm that pain is a frequent and important
symptom in patients with DM2, affecting quality of life. Peripheral mechanisms of
pain seem to play a role in DM2. The widespreadness of the hyperalgesia suggests central
sensitization, but this finding was not supported by the other results. This study
opens new avenues for further research and eventually novel treatment strategies,
in DM2 as well as in other muscular disorders.
Perspective
This article presents qualitative as well as quantitative aspects of pain in patients
with DM2. Pain is a frequent and important symptom in patients with DM2, affecting
quality of life. We found mechanical hyperalgesia, indicative of a peripheral mechanism
of pain. The widespreadness of hyperalgesia may suggest central sensitization, but
this finding was not supported by other results and needs further exploration.
Key words
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Article info
Publication history
Published online: March 27, 2018
Accepted:
March 14,
2018
Received in revised form:
February 18,
2018
Received:
July 30,
2017
Footnotes
This study was sponsored by Fonds NutsOhra (1301-057).
A.V. received honoraria from serving as a consultant for Leadiant Biosciences, Inc, USA and Leadiant Biosciences Ltd, United Kingdom. B.G.M.v.E. reports grants from Prinses Beatrix Spierfonds, Association Française contre les Myopathies, Stichting Spieren voor Spieren, FSHD Stichting, NWO, and Euroimmune, outside of the submitted work; and a patent EP2012740236 licensed to Euroimmune. The remaining authors have no conflicts of interest to declare.
Identification
Copyright
© 2018 by the American Pain Society
