The Pain in Neuropathy Study (PiNS)
Disabling neuropathic pain (NeuP) is a common sequel of diabetic peripheral neuropathy (DPN). We aimed to characterise the sensory phenotype of patients with and without NeuP, assess screening tools for NeuP, and relate DPN severity to NeuP. The Pain in Neuropathy Study (PiNS) is an observational cr...
| Hauptverfasser: | , , , , , , , , |
|---|---|
| Format: | Journal article |
| Sprache: | English |
| Veröffentlicht: |
Wolters Kluwer Health, Inc
2016
|
| _version_ | 1826263120723574784 |
|---|---|
| author | Themistocleous, A Ramirez, J Shillo, P Lees, J Selvarajah, D Orengo, C Tesfaye, S Rice, A Bennett, D |
| author_facet | Themistocleous, A Ramirez, J Shillo, P Lees, J Selvarajah, D Orengo, C Tesfaye, S Rice, A Bennett, D |
| author_sort | Themistocleous, A |
| collection | OXFORD |
| description | Disabling neuropathic pain (NeuP) is a common sequel of diabetic peripheral neuropathy (DPN). We aimed to characterise the sensory phenotype of patients with and without NeuP, assess screening tools for NeuP, and relate DPN severity to NeuP. The Pain in Neuropathy Study (PiNS) is an observational cross-sectional multicentre study. A total of 191 patients with DPN underwent neurological examination, quantitative sensory testing, nerve conduction studies, and skin biopsy for intraepidermal nerve fibre density assessment. A set of questionnaires assessed the presence of pain, pain intensity, pain distribution, and the psychological and functional impact of pain. Patients were divided according to the presence of DPN, and thereafter according to the presence and severity of NeuP. The DN4 questionnaire demonstrated excellent sensitivity (88%) and specificity (93%) in screening for NeuP. There was a positive correlation between greater neuropathy severity (r = 0.39, P < 0.01), higher HbA1c (r = 0.21, P < 0.01), and the presence (and severity) of NeuP. Diabetic peripheral neuropathy sensory phenotype is characterised by hyposensitivity to applied stimuli that was more marked in the moderate/severe NeuP group than in the mild NeuP or no NeuP groups. Brush-evoked allodynia was present in only those with NeuP (15%); the paradoxical heat sensation did not discriminate between those with (40%) and without (41.3%) NeuP. The “irritable nociceptor” subgroup could only be applied to a minority of patients (6.3%) with NeuP. This study provides a firm basis to rationalise further phenotyping of painful DPN, for instance, stratification of patients with DPN for analgesic drug trials. |
| first_indexed | 2024-03-06T19:46:40Z |
| format | Journal article |
| id | oxford-uuid:22859d9d-f5de-4ca3-9ec1-b8fca5fac505 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:46:40Z |
| publishDate | 2016 |
| publisher | Wolters Kluwer Health, Inc |
| record_format | dspace |
| spelling | oxford-uuid:22859d9d-f5de-4ca3-9ec1-b8fca5fac5052022-03-26T11:39:17ZThe Pain in Neuropathy Study (PiNS)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:22859d9d-f5de-4ca3-9ec1-b8fca5fac505EnglishSymplectic Elements at OxfordWolters Kluwer Health, Inc2016Themistocleous, ARamirez, JShillo, PLees, JSelvarajah, DOrengo, CTesfaye, SRice, ABennett, DDisabling neuropathic pain (NeuP) is a common sequel of diabetic peripheral neuropathy (DPN). We aimed to characterise the sensory phenotype of patients with and without NeuP, assess screening tools for NeuP, and relate DPN severity to NeuP. The Pain in Neuropathy Study (PiNS) is an observational cross-sectional multicentre study. A total of 191 patients with DPN underwent neurological examination, quantitative sensory testing, nerve conduction studies, and skin biopsy for intraepidermal nerve fibre density assessment. A set of questionnaires assessed the presence of pain, pain intensity, pain distribution, and the psychological and functional impact of pain. Patients were divided according to the presence of DPN, and thereafter according to the presence and severity of NeuP. The DN4 questionnaire demonstrated excellent sensitivity (88%) and specificity (93%) in screening for NeuP. There was a positive correlation between greater neuropathy severity (r = 0.39, P < 0.01), higher HbA1c (r = 0.21, P < 0.01), and the presence (and severity) of NeuP. Diabetic peripheral neuropathy sensory phenotype is characterised by hyposensitivity to applied stimuli that was more marked in the moderate/severe NeuP group than in the mild NeuP or no NeuP groups. Brush-evoked allodynia was present in only those with NeuP (15%); the paradoxical heat sensation did not discriminate between those with (40%) and without (41.3%) NeuP. The “irritable nociceptor” subgroup could only be applied to a minority of patients (6.3%) with NeuP. This study provides a firm basis to rationalise further phenotyping of painful DPN, for instance, stratification of patients with DPN for analgesic drug trials. |
| spellingShingle | Themistocleous, A Ramirez, J Shillo, P Lees, J Selvarajah, D Orengo, C Tesfaye, S Rice, A Bennett, D The Pain in Neuropathy Study (PiNS) |
| title | The Pain in Neuropathy Study (PiNS) |
| title_full | The Pain in Neuropathy Study (PiNS) |
| title_fullStr | The Pain in Neuropathy Study (PiNS) |
| title_full_unstemmed | The Pain in Neuropathy Study (PiNS) |
| title_short | The Pain in Neuropathy Study (PiNS) |
| title_sort | pain in neuropathy study pins |
| work_keys_str_mv | AT themistocleousa thepaininneuropathystudypins AT ramirezj thepaininneuropathystudypins AT shillop thepaininneuropathystudypins AT leesj thepaininneuropathystudypins AT selvarajahd thepaininneuropathystudypins AT orengoc thepaininneuropathystudypins AT tesfayes thepaininneuropathystudypins AT ricea thepaininneuropathystudypins AT bennettd thepaininneuropathystudypins AT themistocleousa paininneuropathystudypins AT ramirezj paininneuropathystudypins AT shillop paininneuropathystudypins AT leesj paininneuropathystudypins AT selvarajahd paininneuropathystudypins AT orengoc paininneuropathystudypins AT tesfayes paininneuropathystudypins AT ricea paininneuropathystudypins AT bennettd paininneuropathystudypins |