Pain, cognition, and ADL in Huntington's Disease.

Quinten, S.M. (Sussan) (2008) Pain, cognition, and ADL in Huntington's Disease. thesis, Human Movement Sciences.

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Abstract

Background: Based on the course of the neuropathology in Huntington's Disease (HD) in relation with the pain system, HD patients are expected to have an altered pain processing in both the lateral (sensory-discriminative aspects), as well as the medial (motivational-affective, cognitive-evaluative and autonomic aspects) pain system. However, pain as a symptom ofHD, or somatosensory symptoms in general, have received little attention so far. The main goal of the present study is therefor to examine whether pain is a clinical symptom in HD. In addition, in general it is assumed that there exists a positive relationship between pain experience and cognition. Therefor, an additional focus of the present study lies on whether such a relationship could also be established in a group of HD patients. Pain may also be related to in which amount the patient is still able to take care of him or herself in daily life. Consequently, the third goal of the present study is to examine a possible relationship between pain experience and functioning in ADL in HD patients. Methods: A group of six HD patients (3 female, 3 male) and six control subjects (4 female, 2 male) participated in this study. To assess pain intensity and pain affect, the Coloured Analogue Scale (CAS) -Intensity, CAS- Affect, the Faces Pain Scale (FPS), and the Number of Words Chosen- Affective (NWC-A) were performed. Cognitive functioning was examined by assessing Digit Span forward and backward, Face Recognition, Picture Recognition, Wordfluency, Incomplete Figures, and the Rule Shift Cards test. Possible confounders like age, education, vital and gnostic sensibility, comorbidity, and drug use were registrated. To exclude the influence of mood, depression was inventorized by the Beck Depression Inventory (BDI) and the Symptom Checklist (SCL -90) subscale depression, and anxiety by the SCL-90 subscale anxiety. Results: There is a tendency of HD patients having higher scores on both pain intensity and pain affect than controls. Effect sizes range from small (0,134) to large (0,913). Significant relationships could be found for Digit span backward and three out of four pain measurements (CAS -Intensity, FPS and NWC-A) and for the depression and anxiety scale of the SCL-90 and NWC-A in HD patients. For the control group only the relationship for the depression scale of the SCL-90 and the CAS - Affect was found to be significant. Correlations between ADL functioning and pain intensity and pain affect variated from moderate (0,300) to high (0,791), although results were not significant. Conclusions: Due to the small number of participants in the present study, no firm conclusions could be drawn. However, there seems to be a tendency of HD patients having both higher pain intensity and pain affect than controls. No conclusive relationships between pain and cognitive functioning and ADL functioning could be established so far, although results pointed in the expected direction. Results should be confirmed in future studies, before practical consequences in the health care of HD patients can be attached. Limitations of the present study are discussed.

Item Type:	Thesis (Thesis)
Supervisor name:	Scherder, Prof. Dr. E.J.A.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:00
Last Modified:	25 Jun 2020 11:00
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2000

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