Pain characteristics in acromegalic patients compared to patients with non-functioning pituitary adenomas

Abstract

Although it is known that patients with pituitary adenomas, especially acromegaly suffer from pain syndromes, little is known about extent, characteristics and underlying predictors. In this cross-sectional study (conducted at the Max Planck Institute of Psychiatry in cooperation with the Department of Internal Medicine of the Ludwig Maximilians University in Munich), we investigated specific pain patterns in acromegalic patients (n=81) compared to patients with non-functioning pituitary adenomas (n=60) using three standardized pain questionnaires. All three questionnaires (MIDAS “Migraine Disability Assessment“, the painDETECT, and the DGSS questionnaire) revealed a high burden of diverse pain syndromes in patients with pituitary adenomas. Regarding days of headache within the last three months and headache intensity, the values of acromegalic patients and patients with non-functioning pituitary adenomas were not significantly different (mean 9.9±22.3 vs. 7.6±16.8 days; p=0.529, pain intensity scale: 0=no pain, 10=highest intensity; mean 3.1±3.4 vs. 1.9±2.8; p=0.391). The screening for neuropathic vs. nociceptive pain with the painDETECT questionnaire did not show significant differences between both groups in most of the domains (i.e. pain intensity mean 2.7±2.7 vs. 1.9±2.3; p=0.501; highest pain intensity during the past 4 weeks mean 5.1±3.1 vs. 4.0±2.9; p=0.148). Conclusions: Pain is a frequent comorbidity both in acromegalic and non-functioning pituitary adenoma patients. Further studies to further elucidate the underlying patterns and contributing mechanisms are underway and will be a prerequisite for adequate future pain treatment in these patients.