A Review of the Clinical and Therapeutic Implications of Neuropathic Pain
Abstract
:1. Introduction
2. Pathophysiologic Mechanisms Underlying Neuropathic Pain
3. Diagnosing Neuropathic Pain
4. Treatment of Neuropathic Pain
5. Biomarkers and Neuropathic Pain
6. Future Perspectives: Molecular Alterations and Tailored Therapy
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Tool | Consistencies | How and When to Use It |
---|---|---|
Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) | It requires a physical examination. 85% sensitivity and 80% specificity [15]. | S-LANSS is the self-reported form. Positive scores on the LANSS or S-LANSS identify patients with pain of predominantly neuropathic origin. |
Neuropathic Pain Questionnaire (NPQ) | 66% sensitivity and 74% specificity [15]. | 12 items that include 10 related to sensations or sensory responses, and 2 related to affect. |
Douleur Neuropathique 4 Questions | It requires a physical examination. 83% sensitivity and 90% specificity [15]. | 7 items. A score of 4 out of 10 or more suggests neuropathic pain |
painDETECT | Self-reported 85% sensitivity and 80% specificity [15]. | 9 items. It can be used in neuropathic, nociceptive pain, and low back pain. |
Standardised Evaluation of Pain (StEPS) | It requires a physical examination. 92% sensitivity and 97% specificity [16]. | It can be used to discriminate between neuropathic (radicular) and non-neuropathic (axial) low back pain. |
Neuropathic Pain Scale (NPS) | NA | The NPS quantifies already-diagnosed neuropathic pain. 10 items. A score of more than 4 suggests neuropathic pain |
Pain Quality Assessment Scale (PQAS) | Self-reported | 20 items. It provides the pain qualities. |
ID-Pain | 78% sensitivity and 74% specificity [17]. | 5 sensory descriptor items and 1 item relating joint nociceptive pain. |
Neuropathic Pain Symptom Inventory (NPSI) | Self-reported. 91% sensitivity and 70% specificity [18]. | Characterize subgroups of neuropathic pain patients. |
Neuropathic Pain scale for Postsurgical patients (NeuPPS) | 88% sensitivity and 59% specificity [19]. | 5 items. Measurement of neuropathic pain among postsurgical patients. |
Author | Biomarker | Sample | Pathology | Evidence |
---|---|---|---|---|
Assi et al. [55] | Thrombospondin 4 | Serum | Advanced osteoarthritic neuropathic states | Correlation was demonstrated |
Balagué et al. [56] | Keratan sulfate, hyaluronan, and cartilage oligomeric matrix protein | Peripheral blood | Sciatica | No correlation with clinical outcome |
Dietz et al. [57] | hsa-miR-223-5p | Plasma | Complex regional pain syndrome | Correlation was demonstrated |
Ramanathan et al. [58] | miRNAs | HEK293 cells | Complex regional pain syndrome | Correlation was demonstrated |
Ericson et al. [59] | Tumor necrosis factor—related apoptosis inducing ligand, Tumor necrosis factor-beta | Cerebrospinal fluid | Trigeminal neuralgia | Correlation was demonstrated |
Hayakawa et al. [60] | Lysophospholipids | Cerebrospinal fluid | Lumbar spinal stenosis | Correlation was demonstrated |
Hider et al. [61] | Tumor necrosis factor-alpha, IL-6 and matrix metalloproteinases | Serum | Sciatica | No correlation with clinical outcome |
Kallman et al. [62] | Beta-endorphin and substance P | Saliva and salivary-to-plasma quotients | Chronic neuropathic pain patients | No correlation with clinical outcome |
Karakulova et al. [63] | Brain-derived neurotrophic factor and vascular endothelial growth factor and TrkB, VEGFR2 | Serum | Diabetic polyneuropathy | Correlation with clinical outcome |
Kwon et al. [64] | IL-6, IL-8, and MCP-1 | Cerebrospinal fluid | Spinal cord injury | Correlation with clinical outcome |
Lind et al. [65] | Follistatin, interleukin-1 alpha, and kallikrein-5 | Cerebrospinal fluid | Neuropathic pain patients | No correlation with clinical outcome |
Radojcic et al. [66] | C1M and IL-6 | Serum | End-stage knee osteoarthritis | Correlation with clinical outcome |
Ri et al. [67] | Lysophosphatidylcholine and phosphatidylcholine | Serum/plasma | Bortezomib-induced peripheral neuropathy | Correlation with clinical outcome |
Ri et al. [68] | Lipid metabolites (1 ether-type lysophosphatidylcholine, 1 PC, 1 ceramide, 1 diacylglycerol, 1 triacylglycerol, and 9 oxFAs) | Serum | Bortezomib-induced peripheral neuropathy | Correlation with clinical outcome |
Staats Pires et al. [69] | Major kynurenine and tetrahydrobiopterin pathway metabolites | Serum | Diabetic polyneuropathy | Correlation with clinical outcome |
Wang et al. [70] | microRNAs (mir-204-5p, mir-519d-3p, mir-20b-5p, mir-6838-5p) | Peripheral blood sample | Spinal cord injury | Not clear correlation |
Xu et al. [71] | Tumor necrosis factor-alpha and interleukin-6 | Peripheral blood sample | Spinal cord injury | Correlation with tumor necrosis factor-alpha and clinical outcome |
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Balzani, E.; Fanelli, A.; Malafoglia, V.; Tenti, M.; Ilari, S.; Corraro, A.; Muscoli, C.; Raffaeli, W. A Review of the Clinical and Therapeutic Implications of Neuropathic Pain. Biomedicines 2021, 9, 1239. https://doi.org/10.3390/biomedicines9091239
Balzani E, Fanelli A, Malafoglia V, Tenti M, Ilari S, Corraro A, Muscoli C, Raffaeli W. A Review of the Clinical and Therapeutic Implications of Neuropathic Pain. Biomedicines. 2021; 9(9):1239. https://doi.org/10.3390/biomedicines9091239
Chicago/Turabian StyleBalzani, Eleonora, Andrea Fanelli, Valentina Malafoglia, Michael Tenti, Sara Ilari, Annette Corraro, Carolina Muscoli, and William Raffaeli. 2021. "A Review of the Clinical and Therapeutic Implications of Neuropathic Pain" Biomedicines 9, no. 9: 1239. https://doi.org/10.3390/biomedicines9091239