Development and Validation of the Dystonia-Pain Classification System: A Multicenter Study

• Autores: Listik, Clarice; Listik, Eduardo; santos, Flavia de Paiva; Portela, Denise Maria Meneces Cury; Perez Lloret, Santiago; Araújo, Natália Rebeca de Alves; Carvalho, Pedro Rubens Araújo; Santos, Graziele Costa; Limongi, João Carlos Papaterra; Cardoso, Francisco; Mylius, Veit; Brugger, Florian; Fernandes, Ana Mercia; Barbosa, Egberto Reis; Teixeira, Manoel Jacobsen; Cury, Rubens Gisbert; Andrade, Daniel Ciampi de
• Año de publicación: 2023
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: chronic pain; dystonia; non motor symptoms; pain
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Background Dystonia is associated with disabling nonmotor symptoms like chronic pain (CP), which is prevalent in dystonia and significantly impacts the quality of life (QoL). There is no validated tool for assessing CP in dystonia, which substantially hampers pain management. Objective The aim was to develop a CP classification and scoring system for dystonia. Methods A multidisciplinary group was established to develop the Dystonia-Pain Classification System (Dystonia-PCS). The classification of CP as related or unrelated to dystonia was followed by the assessment of pain severity score, encompassing pain intensity, frequency, and impact on daily living. Then, consecutive patients with inherited/idiopathic dystonia of different spatial distribution were recruited in a cross-sectional multicenter validation study. Dystonia-PCS was compared to validated pain, mood, QoL, and dystonia scales (Brief Pain Inventory, Douleur Neuropathique-4 questionnaire, European QoL-5 Dimensions-3 Level Version, and Burke–Fahn–Marsden Dystonia Rating Scale). Results CP was present in 81 of 123 recruited patients, being directly related to dystonia in 82.7%, aggravated by dystonia in 8.8%, and nonrelated to dystonia in 7.5%. Dystonia-PCS had excellent intra-rater (Intraclass Correlation Coefficient - ICC: 0.941) and inter-rater (ICC: 0.867) reliability. In addition, pain severity score correlated with European QoL-5 Dimensions-3 Level Version's pain subscore (r = 0.635, P < 0.001) and the Brief Pain Inventory's severity and interference scores (r = 0.553, P < 0.001 and r = 0.609, P < 0.001, respectively). Conclusions Dystonia-PCS is a reliable tool to categorize and quantify CP impact in dystonia and will help improve clinical trial design and management of CP in patients affected by this disorder.
Fil: Listik, Clarice. Universidade Federal de Sao Paulo.; Brasil
Fil: Listik, Eduardo. University of Alabama at Birmingahm; Estados Unidos
Fil: santos, Flavia de Paiva. Hospital Geral de Fortaleza; Brasil
Fil: Portela, Denise Maria Meneces Cury. Instituto de Ensino Superior do Piaui; Brasil
Fil: Perez Lloret, Santiago. Universidad Abierta Interamericana. Vicerrectoria de Investigación. Centro de Altos Estudios En Ciencias Sociales.; Argentina. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Araújo, Natália Rebeca de Alves. Instituto de Ensino Superior do Piaui; Brasil
Fil: Carvalho, Pedro Rubens Araújo. Hospital Geral de Fortaleza; Brasil
Fil: Santos, Graziele Costa. Universidade Federal de Sao Paulo; Brasil
Fil: Limongi, João Carlos Papaterra. Universidade de Sao Paulo; Brasil
Fil: Cardoso, Francisco. Universidade Federal de Minas Gerais; Brasil
Fil: Mylius, Veit. Philipps University; Alemania. Center for Neurorehabilitation; Suiza
Fil: Brugger, Florian. Kantonsspital St. Gallen; Suiza
Fil: Fernandes, Ana Mercia. Universidade de Sao Paulo; Brasil
Fil: Barbosa, Egberto Reis. Universidade de Sao Paulo; Brasil
Fil: Teixeira, Manoel Jacobsen. Universidade Federal de Minas Gerais; Brasil
Fil: Cury, Rubens Gisbert. Universidade de Sao Paulo; Brasil
Fil: Andrade, Daniel Ciampi de. Universidade de Sao Paulo; Brasil. Aalborg University; Dinamarca