جنبه های کیفی و کمی درد در بیماران مبتلا به نوع دیستروفی میوتونی نوع 2

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 by means of four questionnaires and quantitative sensory testing. Both a disease control group (fibromyalgia (FMS)) and healthy controls were used to compare the results, as 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, both age- and sex-matched. Pain prevalence was 65% in DM2, 100% in FMS (P < 0.001) and 15% in healthy controls (P < 0.001). The mean of the pressure pain thresholds was lower in DM2 than in healthy controls (P = 0.016), 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, 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, both in DM2 as well as other muscular disorders.