The following is a summary of “Phenotyping Pain in Patients With Fibrous Dysplasia/McCune-Albright Syndrome,” published in the March 2024 issue of Endocrinology by Golden, et al.

For a prospective, single-site study, researchers sought to identify neuropsychological and neurobiological factors associated with pain severity in patients with fibrous dysplasia/McCune-Albright syndrome (FD/MAS). The study included 20 patients with FD/MAS and 16 age-sex-matched healthy controls.

Using thermal quantitative sensory testing, they assessed pain severity, neuropathic pain, pain catastrophizing (including pain rumination, magnification, and helplessness), emotional health, and pain sensitivity. Additionally, we evaluated central nervous system (CNS) properties using diffusion tensor imaging, structural magnetic resonance imaging, and functional magnetic resonance imaging.

The findings revealed that pain severity in patients with FD/MAS was linked to more neuropathic pain quality, higher levels of pain catastrophizing, and depression. Quantitative sensory testing showed normal detection of nonnoxious stimuli in patients, but they exhibited higher pain tolerances compared to healthy controls. Neuroimaging studies indicated that greater pain severity, neuropathic pain quality, and psychological distress were associated with reduced structural integrity of white matter pathways (such as the superior thalamic radiation and uncinate fasciculus) and decreased gray matter thickness (in regions like the pre-/paracentral gyri). Moreover, heightened pain responses were observed in areas such as the precentral, temporal, and frontal gyri, indicating altered CNS circuits involved in processing sensorimotor and emotional aspects of pain in FD/MAS.

In conclusion, the study provided insights into the mechanisms of pain in FD/MAS and underscored the importance of implementing comprehensive pain management strategies that address both neuropsychological and neurobiological aspects of pain in these patients.

Reference: academic.oup.com/jcem/article-abstract/109/3/771/7296037