Sensory phenotype and risk factors for painful diabetic neuropathy: a cross-sectional observational study
| Autor: | Ivana Kovalova, Lucas Forer, Jana Raputová, Jindrich Olsovsky, Frank Birklein, Blanka Adamová, Iva Šrotová, Eva Vlčková, Josef Bednarik, Nurcan Üçeyler, Jana Belobradkova, Claudia Sommer, Ladislav Dušek, Pavel Weber, Jiri Jarkovsky, Cora Rebhorn, Heike L. Rittner, Eva Králíčková Nekvapilová |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Diabetic neuropathy Analgesic 030209 endocrinology & metabolism Neurological examination Cohort Studies 03 medical and health sciences Polyneuropathies Young Adult 0302 clinical medicine Diabetic Neuropathies Risk Factors Internal medicine Diabetes mellitus medicine Humans Aged Aged 80 and over Neurologic Examination medicine.diagnostic_test business.industry Middle Aged medicine.disease Anesthesiology and Pain Medicine Cross-Sectional Studies Phenotype Neurology Neuropathic pain Physical therapy Neuralgia Pain catastrophizing Female Neurology (clinical) business Polyneuropathy 030217 neurology & neurosurgery Cohort study |
| Zdroj: | PAIN |
| ISSN: | 1872-6623 |
| Popis: | Different sensory profiles in diabetic distal symmetrical sensory-motor polyneuropathy (DSPN) may be associated with pain and the responsiveness to analgesia. We aimed to characterize sensory phenotypes of patients with painful and painless diabetic neuropathy and to assess demographic, clinical, metabolic, and electrophysiological parameters related to the presence of neuropathic pain in a large cohort of well-defined DSPN subjects. This observational cross-sectional multi-center cohort study (performed as part of the ncRNAPain EU consortium) of 232 subjects with nonpainful (n = 74) and painful (n = 158) DSPN associated with diabetes mellitus of type 1 and 2 (median age 63 years, range 21-87 years; 92 women) comprised detailed history taking, laboratory tests, neurological examination, quantitative sensory testing, nerve conduction studies, and neuropathy severity scores. All parameters were analyzed with regard to the presence and severity of neuropathic pain. Neuropathic pain was positively correlated with the severity of neuropathy and thermal hyposensitivity (P < 0.001). A minority of patients with painful DSPN (14.6%) had a sensory profile, indicating thermal hypersensitivity that was associated with less severe neuropathy. Neuropathic pain was further linked to female sex and higher cognitive appraisal of pain as assessed by the pain catastrophizing scale (P < 0.001), while parameters related to diabetes showed no influence on neuropathic pain with the exception of laboratory signs of nephropathy. This study confirms the value of comprehensive DSPN phenotyping and underlines the importance of the severity of neuropathy for the presence of pain. Different sensory phenotypes might be useful for stratification of patients with painful DSPN for analgesic treatment and drug trials. |
| Databáze: | OpenAIRE |
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