Publication details

Sensory phenotype and risk factors for painful diabetic neuropathy: a cross-sectional observational study

Authors

RAPUTOVÁ Jana ŠROTOVÁ Iva VLČKOVÁ Eva SOMMER Claudia ÜCEYLER Nurcan BIRKLEIN Frank RITTNER Heike L. REBHORN Cora ADAMOVÁ Blanka KOVAĽOVÁ Ivana KRÁLÍČKOVÁ NEKVAPILOVÁ Eva FORER Lucas BĚLOBRÁDKOVÁ Jana OLŠOVSKÝ Jindřich WEBER Pavel DUŠEK Ladislav JARKOVSKÝ Jiří BEDNAŘÍK Josef

Year of publication 2017
Type Article in Periodical
Magazine / Source Pain
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1097/j.pain.0000000000001034
Field Neurology, neurosurgery, neurosciences
Keywords diabetic neuropathy
Description 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.

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