Objective: To improve the classification system for pain in dystonia.

Background: Pain is a frequent and incapacitating non-motor symptom in dystonia. Evidence indicates that pain in dystonia is not only of muscular origin, but pain’s descending modulatory systems are impaired in dystonia. There is much to be learned about this topic. Still, we do not have a simple and straightforward way to classify, evaluate pain, and assess its improvement after pharmacological, surgical, and non-invasive treatments.

Method: We evaluated 36 patients in a multicentric study with hereditary/idiopathic dystonia of any distribution. These results are preliminary finds of this multicentric assessment. We applied the Burke-Fahn-Marsden (BFM) dystonia scale, two pain scales (Douleur Neuropathique – DN4 and the short-form Brief Pain Inventory – BPI), and our developed classification system.

Results: Patients (54.9 ± 14.6 years, 41.7% male) had a BFM motor and disability subscores of 17.6 ± 6.8 and 4.5 ± 5.7, respectively, and 15 patients (41.7%) had chronic pain. Four patients had chronic pain non-related to dystonia, and 11 patients had chronic pain directly related to dystonia. Six patients had a second chronic pain, one of which was aggravated by dystonia, and five were directly associated with dystonia. DN4 was 2.1 ± 1.9, and BPI pain severity 5.2 ± 2.0 interference 5.0 ± 3.2.

Conclusion: Chronic pain is prevalent in dystonic patients and is frequently directly related to dystonia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/classifying-pain-in-dystonia-a-way-to-improve-pain-outcome-measure-in-dystonia/