White matter hyperintensities are related to pain intensity in an outpatient memory clinic population: Preliminary findings

Tarik T Binnekade, Roberto Sgm Perez, Andrea B Maier, Hanneke Fm Rhodius-Meester, Nienke Legdeur, Marijke C Trappenburg, Didi Rhebergen, Frank Lobbezoo, Erik Ja Scherder

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: The association between pain and dementia is complicated and may depend on underlying brain pathology. It was hypothesized that both medial temporal atrophy (MTA) and global cortical atrophy (GCA) predicted no/mild pain, while white matter hyperintensities (WMH) predicted moderate/severe pain. Objectives: To study the association between pain intensity and measures of brain pathology, more specifically MTA, GCA, and WMH. Methods: In total, 115 consecutive patients visiting an outpatient memory clinic were included. In total, diagnoses included dementia (N=70), mild cognitive impairment (N=30), and subjective cognitive impairment (N=15). Without administering stimuli, pain intensity was assessed with the Brief Pain Inventory. MTA, GCA, and WMH were measured with a MRI visual rating scale. Logistic regression analyses to examine the relationship between WMH, MTA, GCA, and self-reported pain intensity (no/mild pain versus moderate/severe pain) were adjusted for confounders. Results: Mean age of the patients was 81 years (IQR: 78-85, 53% female). Moderate/severe pain was reported by 23.5% and associated with greater WMH (OR =3.34, 95% CI =1.01-10.97, p=0.047), but not MTA or GCA. Conclusions: In contrast to the present results, earlier studies have reported either a positive or negative relationship between pain and brain volume. It is suggested that the presence of dementia may explain the absence of a relationship between pain and brain volume. WMH is positively related with pain in an older memory outpatient population. Considering the small sample size, our findings should be interpreted with caution. Hence, our conclusions are preliminary findings, warranting future replication.

Original languageEnglish
Pages (from-to)1621-1629
Number of pages9
JournalJournal of Pain Research
Volume12
DOIs
Publication statusPublished - 22 May 2019

Funding

Tarik T Binnekade reports grants from Amstelring, Alzheimer Nederland, Fund Nuts Ohra care subsidies, Roomsch Catholijk Oude Armen Kantoor, Stichting Beroepsopleiding Huisartsen, Stichting Henriëtte Hofje, and the Arnold Oosterbaan Brain Foundation, during the conduct of the study. F Lobbezoo reports a research grant as a member of Academic Advisory Board from Sunstar Suisse and a research grant from Somnomed outside the submitted work. The other authors report no conflicts of interest in this work. We thank the staff of the Centrumvoor Ouderengeneeskunde Amsterdam (COGA) and Behandeladvies Centrum Ouderengeneeskunde (BACO) (VU University Medical Center Amsterdam/Amstelland Hospital) for their contribution in collecting the data. We mourn the loss of Professor Doctor Roberto SGM Perez and acknowledge his important contribution to our study of pain in dementia and the conception of the current manuscript. The primary author, Tarik T Binnekade, is funded by Amstelring (RVB U-9107-2013/ HM/wb), Alzheimer Nederland (WE.09-2012-02), Fonds Nuts Ohra (1130-046), Roomsch Catholijk Oude Armen Kantoor (RCOAK) (2010.351), Stichting Beroepsopleiding Huisartsen (SBOH), Stichting Henri?tte Hofje (2010.351H), and the Arnold Oosterbaan Brain Foundation. The findings reported in this article are those of the authors and should not be attributed to any of the funding parties. We thank the staff of the Centrum voor Ouderengeneeskunde Amsterdam (COGA) and Behandeladvies Centrum Ouderengeneeskunde (BACO) (VU University Medical Center Amsterdam/Amstelland Hospital) for their contribution in collecting the data. We mourn the loss of Professor Doctor Roberto SGM Perez and acknowledge his important contribution to our study of pain in dementia and the conception of the current manuscript. The primary author, Tarik T Binnekade, is funded by Amstelring (RVB U-9107-2013/ HM/wb), Alzheimer Nederland (WE.09-2012-02), Fonds Nuts Ohra (1130-046), Roomsch Catholijk Oude Armen Kantoor (RCOAK) (2010.351), Stichting Beroepsopleiding Huisartsen (SBOH), Stichting Henriëtte Hofje (2010.351H), and the Arnold Oosterbaan Brain Foundation. The findings reported in this article are those of the authors and should not be attributed to any of the funding parties.

FundersFunder number
Alzheimer Nederland, Fund Nuts Ohra care subsidies
Arnold Oosterbaan Brain Foundation
Behandeladvies Centrum Ouderengeneeskunde
Fonds Nuts Ohra1130-046
Roomsch Catholijk Oude Armen Kantoor2010.351
Stichting Henriëtte Hofje
Sunstar Suisse
VU University Medical Center Amsterdam/Amstelland HospitalRVB U-9107-2013/ HM/wb, WE.09-2012-02
Stichting Beroepsopleiding Huisarts2010.351H

    Keywords

    • Alzheimer’s disease
    • Brain atrophy
    • Dementia
    • Pain
    • White matter hyperintensities

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