Development and validation of the Neuropathic Pain Symptom Inventory

Abstract

This study describes the development and validation of the Neuropathic Pain Symptom Inventory (NPSI), a new self-questionnaire specifically designed to evaluate the different symptoms of neuropathic pain. Following a development phase and a pilot study, we generated a list of descriptors reflecting spontaneous ongoing or paroxysmal pain, evoked pain (i.e. mechanical and thermal allodynia/hyperalgesia) and dysesthesia/paresthesia. Each of these items was quantified on a (0-10) numerical scale. The validation procedure was performed in 176 consecutive patients with neuropathic pain of peripheral (n = 120) or central (n = 56) origin, recruited in five pain centers in France and Belgium. It included: (i) assessment of the test-retest reliability of each item, (ii) determination of the factorial structure of the questionnaire and analysis of convergent and divergent validities (i.e. construct validity), and (iii) evaluation of the ability of the NPSI to detect the effects of treatment (i.e. sensitivity to change). The final version of the NPSI includes 10 descriptors (plus two temporal items) that allow discrimination and quantification of five distinct clinically relevant dimensions of neuropathic pain syndromes and that are sensitive to treatment. The psychometric properties of the NPSI suggest that it might be used to characterize subgroups of neuropathic pain patients and verify whether they respond differentially to various pharmacological agents or other therapeutic interventions.

Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?

“…Negative symptoms or signs (ie, sensory deficits) were not included in these analyses, since they are expected to be more directly associated with nerve lesions. We assessed symptoms and dimensions with the Neuropathic Pain Symptom Inventory (NPSI), a recently validated questionnaire specifically designed for such a purpose (8). We also confirmed the internal structure of the NPSI and determined its relevance to evaluation of symptoms of evoked pain by exploring their relationships with clinician-based quantified measures (i.e.…”

“…They were asked to rate the mean intensity of their pain during the last 24 hours on an 11-point (0-10) numerical scale on the neuropathic pain symptom inventory (NPSI) (8). This questionnaire includes ten symptoms most commonly described by neuropathic patients (burning, pressure, squeezing, electric shocks, stabbing; pain evoked by brushing, pressure, or cold; tingling, pins and needles).…”

“…We have recently shown that positive symptoms pertained to distinct dimensions (i.e. superficial pain, deep pain, paroxysmal pain, evoked pain) (8). However, it is unclear whether the multidimensional nature of NP is related to the aetiology or location of the neurological lesion.…”

“…Thus, such information may be useful for a mechanism-based approach for selecting therapy for neuropathic pain (3,6,7,8,19,37). In particular, identification of subsyndromes corresponding to various combinations of symptoms (related or not to the aetiology) may contribute to reformation of current therapeutic strategies (7,8,19). The traditional aetiology-based categorisation of neuropathic pain still prevails for clinical, experimental (20,21) and pharmacological studies (1,11,14).…”

Pregabalin for the Prevention of Oxaliplatin-Induced Painful Neuropathy: A Randomized, Double-Blind Trial

“…The presence of neuropathic pain characteristics was assessed by the Douleur Neuropathique-4 (0–10, positive ≥4) [31]. Neuropathic Pain Symptom Inventory (0–100) was used for neuropathic pain profiling [32], [33].  Oxaliplatin-Related Neuropathy: The presence of neuropathy was assessed by the reduced version of the total neuropathy score (rTNS) [34] at baseline and at the last visit by blinded neurophysiologists with no other role in the study.…”