Association of neuropathic pain with bladder and bowel dysfunction, functional disability, and quality of life of patients with multiple sclerosis

Objectives: To investigate the association between neuropathic pain (NP) and bladder/bowel dysfunction in multiple sclerosis (MS) and evaluate the association of NP with functional disability, quality of life, anxiety, depression, and sleep quality. Patients and Methods:Patients diagnosed with MS based on the 2017 Revised McDonald criteria between who were between 18 and 65 years of age were included in our study.We analyzed data of 175 patients (56 male, 119 female).The patients were assessed for demographic and clinical characteristics, NP, bladder/bowel dysfunction, disability, health perception and quality of life, anxiety and depression, and sleep quality.Results: MS patients with NP had significantly higher Expanded Disability Status Scale (EDSS) scores, Hospital Anxiety and Depression Scale (HADS) for the subscales anxiety and depression, and Pittsburgh Sleep Quality Index (PSQI) scores (p<0.05).The patients with NP had a higher proportion of female patients and musculoskeletal pain (p<0.05).The patients with NP had significantly lower scores for Functional Independence Measure bladder and bowel scores; Monitoring My Multiple Sclerosis scale physical status, relationships, energy, and cognitive/ mental and total scores.Sex, EDSS scores, HADS scores for anxiety subscale, and PSQI scores for subjective sleep quality subscale were independent predictors of NP (p=0.008,0.002, 0.029, and 0.024, respectively; adjusted R 2 =0.438).Conclusion: Female sex, greater disability, higher anxiety levels, and poorer subjective sleep quality increase the likelihood of NP in MS.We found that bladder and bowel dysfunctions are more common among patients with NP; however, bladder or bowel dysfunction was not a predictor of NP.