• Judith van Vliet, Alide A Tieleman, Aad Verrips, Hans Timmerman, van Dongen Robert T M RTM Department of Neurology, Canisius Wilhelmina Hospital Nijmegen, Nijmegen, The Netherlands; Department of Anesthesiology, Pain and Palliative Med, van Engelen Baziel G M BGM Neuromuscular Center Nijmegen, Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands., and Wilder-Smith Oliver H G OHG Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Center for Sensory-M.
• Department of Neurology, Canisius Wilhelmina Hospital Nijmegen, Nijmegen, The Netherlands; Neuromuscular Center Nijmegen, Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: J.vanVliet@cwz.nl.
• J Pain. 2018 Aug 1; 19 (8): 920-930.

AbstractPain 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 using 4 questionnaires and quantitative sensory testing. A disease control group (fibromyalgia [FMS]) as well as healthy controls were used to compare the results, because 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, age- as well as sex-matched. Pain prevalence was 65% in DM2, 100% in FMS (P < .001), and 15% in healthy controls (P < .001). The mean of the pressure pain thresholds was lower in DM2 than in healthy controls (P = .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, and 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, in DM2 as well as in other muscular disorders.Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

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