What Role Does Multiple Sclerosis Play in the Development of Untreatable Painful Conditions?

Abstract

Clinical data outline the high incidence of pain syndromes in patients with multiple sclerosis, with a significant prevalence of craniofacial manifestations, including trigeminal neuralgia and migraine, which are very difficult to be managed pharmacologically. The common explanation of a localization of demyelinating plaques in areas devoted to pain modulation and integration as a trigger for pain development seems now partially unsatisfactory, since pain is often manifested well before the clinical signs of the pathology and its severity does not correlate with disease progression. This review focuses on additional mechanisms which could be at the basis of pain development in multiple sclerosis, whose identification will help identifying new targets to design more effective analgesic strategies.

Keywords:;:

• astrocytes
• demyelination
• fingolimod (2-amino-2-[2-(4-octylphenyl)ethyl]-1,3-propanediol)
• microglia
• minocycline (7-dimethylamino-6-dimethyl-6-deoxytetracycline)
• neuropathic pain
• satellite glial cells
• trigeminal pain

Financial & competing interests disclosure

The contribution of the Fondazione Italiana Sclerosi Multipla (FISM) grant #2016/R/7 is gratefully acknowledged. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.