Pain, depression, and quality of life in adults with MOG-antibody-associated disease

Susanna Asseyer; Eugenia Henke; Corinna Trebst; Martin W Hümmert; Brigitte Wildemann; Sven Jarius; Marius Ringelstein; Orhan Aktas; Marc Pawlitzki; Melanie Korsen; Luisa Klotz; Nadja Siebert; Klemens Ruprecht; Judith Bellmann-Strobl; Klaus-Dieter Wernecke; Vivien Häußler; Joachim Havla; Anna Gahlen; Ralf Gold; Friedemann Paul; Ingo Kleiter; Ilya Ayzenberg; Neuromyelitis Optica Study Group

doi:10.1111/ene.14729

Pain, depression, and quality of life in adults with MOG-antibody-associated disease

Eur J Neurol. 2021 May;28(5):1645-1658. doi: 10.1111/ene.14729. Epub 2021 Feb 11.

Authors

Susanna Asseyer^{1

2}, Eugenia Henke³, Corinna Trebst⁴, Martin W Hümmert⁴, Brigitte Wildemann⁵, Sven Jarius⁵, Marius Ringelstein^{6

7}, Orhan Aktas⁶, Marc Pawlitzki^{8

9}, Melanie Korsen⁹, Luisa Klotz⁹, Nadja Siebert^{1

2}, Klemens Ruprecht¹⁰, Judith Bellmann-Strobl^{1

2}, Klaus-Dieter Wernecke^{1

2

11}, Vivien Häußler¹², Joachim Havla¹³, Anna Gahlen³, Ralf Gold³, Friedemann Paul^{1

2

10}, Ingo Kleiter^{3

14}, Ilya Ayzenberg^{3

15}; Neuromyelitis Optica Study Group

Affiliations

¹ Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
² NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
³ Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
⁴ Department of Neurology, Hannover Medical School, Hannover, Germany.
⁵ Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
⁶ Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
⁷ Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Düsseldorf, Germany.
⁸ Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.
⁹ Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany.
¹⁰ Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
¹¹ CRO Sostana GmbH, Berlin, Germany.
¹² Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹³ Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany.
¹⁴ Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany.
¹⁵ Department of Neurology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

PMID: 33423336
DOI: 10.1111/ene.14729

Abstract

Background and purpose: Myelin oligodendrocyte glycoprotein-antibody-associated disease (MOGAD) is an inflammatory autoimmune condition of the central nervous system. However, data on pain and depression have remained scarce. The aim of this study was to assess features of chronic pain and depression as well as their impact on health-related quality of life (hr-QoL) in MOGAD.

Methods: Patients with MOGAD were identified in the Neuromyelitis Optica Study Group registry. Data were acquired by a questionnaire, including clinical, demographic, pain (PainDetect, Brief Pain Inventory-Short Form, McGill Pain Questionnaire-Short Form), depression (Beck Depression Inventory-II), and hr-QoL (Short Form-36 Health Survey) items.

Results: Twenty-two of 43 patients suffered from MOGAD-related pain (11 nociceptive, eight definite neuropathic, three possible neuropathic) and 18 from depression. Patients with neuropathic pain had the highest pain intensity and most profound activities of daily living (ADL) impairment. Fifteen patients reported spasticity-associated pain, including four with short-lasting painful tonic spasms. Later disease onset, profound physical impairment, and depression were associated with chronic pain. Physical QoL was more affected in pain sufferers (p < 0.001) than in pain-free patients, being most severely reduced by neuropathic pain (p = 0.016). Pain severity, visual impairment, and gait impairment independently predicted lower physical QoL. Depression was the only factor reducing mental QoL. Twelve patients still suffering from moderate pain (pain severity 4.6 ± 2.3) received pain medication. Only four out of 10 patients with moderate to severe depression took antidepressants.

Conclusions: Being highly prevalent, pain and depression strongly affect QoL and ADL in MOGAD. Both conditions remain insufficiently controlled in real-life clinical practice.

Keywords: MOG-antibody-associated disease; depression; pain; quality of life; spasticity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Adult
Autoantibodies
Chronic Pain* / epidemiology
Depression / epidemiology
Humans
Myelin-Oligodendrocyte Glycoprotein
Quality of Life*

Substances

Autoantibodies
Myelin-Oligodendrocyte Glycoprotein