Risk factors of neuropathic pain in multiple sclerosis: a retrospective case-cohort study
Open accessAbstract
Background: Pain is a common symptom in multiple sclerosis (MS), especially neuropathic pain, which has a significant impact on patients’ mental and physical health and quality of life. However, risk factors that related to neuropathic pain, still remain unclear. Objective: The study aimed to explore the risk factors of neuropathic pain among MS patients. Materials and methods: This retrospective study examined the consecutive patients diagnosed with MS in the Department of Neurology of Guangdong Provincial Hospital of Chinese Medicine between August 2011 and October 2022. Neuropathic pain was defined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system”. Demographic and clinical features were obtained from the electronic system of the hospital. Results: Our cohort revealed that the prevalence of patients with neuropathic pain in MS was 34.1%. The results indicated that the longer the spinal lesions, the greater the neuropathic pain risks (2-4: OR, 13.3(2.1-82), >5: OR, 15.2(2.7-86.8), p for tread: 0.037). Meanwhile, multivariate regression analysis showed that cervical and thoracic lesions (OR 4.276, 95% CI 1.366-13.382, P = 0.013), upper thoracic lesions (T1-T6) (OR 3.047, 95% CI 1.018-9.124, P = 0.046) were positively correlated with neuropathic pain, while basal ganglia lesions (OR 0.188, 95% CI 0.044-0.809, P = 0.025) were negatively correlated with neuropathic pain among MS patients. Conclusion: Extended spinal lesions (≥3 spinal lesions), cervical and thoracic lesions, upper thoracic lesions were independent risk factors of neuropathic pain among MS patients. Furthermore, our study found that the longer the spinal lesions, the greater the neuropathic pain risks.
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Determining whether lesions are neuroanatomically plausible for explaining pain in multiple sclerosis is complex, as the correlation between lesion location and pain is at best moderate-to-good.
“However, determining whether lesions are neuroanatomically plausible for explaining pain in MS is complex, as the correlation between lesion location and pain is at best moderate‐to‐good (Ismail et al. 2025; Ouyang et al. 2024; Seixas et al. 2014; Svendsen et al. 2011).”
From The Prevalence of Neuropathic Pain in Multiple Sclerosis—A Systematic Review and Meta‐Analysis Using the <scp>NeuPSIG</scp> Algorithm (2026) · cites this paper as Ouyang et al. 2024
The Discussion (page unavailable) describes the association between spinal cord lesions and neuropathic pain as controversial and reports that this study did not find the expected associations for thalamic or parietal lesions. That supports the difficulty of interpreting lesion location, but the paper does not characterize the overall lesion-location–pain correlation as “at best moderate-to-good.” (LLM, conf=0.84)
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- Authors
- Ouyang, H., Li, X., Xu, H., Zhan, Y., Zheng, Z., Chen, G., Lou, Z., Chen, H., Zhang, J., Mao, H., Zhang, C., Qin, L., Zhao, Y., & Zhao, M.
- Affiliations
- Guangzhou University of Chinese Medicine (CN)
- Corresponding author
- Zhao, Yuanqi
- Zhao, Min
- Venue
- Frontiers in Immunology
- Publisher
- Frontiers Media SA
- Published
- 2024-01-29
- Volume
- 15
- Pages
- 1309583-1309583
- ISSN
- 1664-3224 (ISSN-L)
- PMC
- PMC10863040
- OpenAlex
- W4391320611
- Cited by
- 9
- References
- 40
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Immunology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Traditional Chinese Medicine Bureau of Guangdong Province
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- multiple sclerosis, neuropathic pain, risk factors, spinal lesions, cervical lesions, thoracic lesions, basal ganglia lesions, pain prevalence
- MeSH terms
- Humans, Multiple Sclerosis, Neuralgia, Quality of Life, Retrospective Studies, Risk Factors, Cohort Studies
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