Somatosensory and psychological phenotypes associated with neuropathic pain in entrapment neuropathy

Matesanz-García, Luis; Hausheer, Andrea Claudia; Baskozos, Georgios; Bennett, David L.H.; Schmid, Annina B.

doi:10.1097/j.pain.0000000000002102

Cited by 18 publications

(59 citation statements)

References 59 publications

(31 reference statements)

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“…We should note though that whereas psychological parameters were more pronounced in patients with CTS compared to healthy volunteers in our study, average scores were not considered clinically relevant. These findings are in line with previous reports in patients with CTS [42].…”

Section: Discussionsupporting

confidence: 94%

“…We recruited patients from surgery waiting lists, which is likely to include more severe profiles. However, symptom and function severity in our study was comparable with previous CTS cohorts from primary care [60] and secondary care [42]. The examiner who performed psychophysical testing could not be blinded to group allocation (CTS vs. healthy).…”

Section: Limitationssupporting

confidence: 76%

“…We identified mechanical hyperalgesia both locally as well as remotely, extraterritorial spread of symptoms and lower efficacy of CPM. Extraterritorial spread of symptoms in patients with CTS is consistently reported in the literature [4,42,43] and has been associated with the presence of central mechanisms. Mechanical hyperalgesia is also commonly interpreted as a sign of central sensitization [44,45].…”

Section: Discussionmentioning

confidence: 81%

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Signs Indicative of Central Sensitization Are Present but Not Associated with the Central Sensitization Inventory in Patients with Focal Nerve Injury

Matesanz-García

Cuenca‐Martínez

Simón

et al. 2022

JCM

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Objective: Carpal tunnel syndrome (CTS) is the most common focal nerve injury. People with CTS may show alterations in central processing of nociceptive information. It remains unclear whether the central sensitization inventory (CSI) is capable of detecting such altered central pain processing. Methods: Thirty healthy volunteers were matched with 30 people with unilateral CTS from the orthopaedic waitlist. Changes to central pain processing were established through psychophysical sensory testing (bilateral pressure pain thresholds (PPT), conditioned pain modulation, temporal summation) and pain distribution on body charts. Patients also completed pain severity and function questionnaires, psychological questionnaires and the CSI. Results: Compared to healthy volunteers, patients with CTS have lower PPTs over the carpal tunnel bilaterally (t = −4.06, p < 0.0001 ipsilateral and t = −4.58, p < 0.0001 contralateral) and reduced conditioned pain modulation efficacy (t = −7.31, p <0.0001) but no differences in temporal summation (t = 0.52, p = 0.60). The CSI was not associated with psychophysical measures or pain distributions indicative of altered central pain processing. However, there was a correlation of the CSI with the Beck Depression Inventory (r = 0.426; p = 0.019). Conclusion: Patients with CTS show signs of altered central pain mechanisms. The CSI seems unsuitable to detect changes in central pain processing but is rather associated with psychological factors in people with focal nerve injuries.

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Section: Discussionsupporting

confidence: 94%

Section: Limitationssupporting

confidence: 76%

Section: Discussionmentioning

confidence: 81%

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Signs Indicative of Central Sensitization Are Present but Not Associated with the Central Sensitization Inventory in Patients with Focal Nerve Injury

Matesanz-García

Cuenca‐Martínez

Simón

et al. 2022

JCM

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“…Median nerve conduction studies in CTS cases evaluate both sensory and motor nerve fibers. Electrophysiological severity classification in CTS is a useful method to show these evaluation parameters on a single scale [ 11 , 12 ], and there are many reports on clinical evaluations using severity classifications [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. However, as shown in this paper, the existing severity classifications do not always accurately reflect the severity of disease, and our results suggest the need to reevaluate previous studies that used these classifications.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome

Sasaki

Koyama

Kuroiwa

et al. 2022

JCM

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Electrophysiological examination is important for the diagnosis and evaluation of nerve function in carpal tunnel syndrome (CTS). Electrophysiological severity classifications of CTS using a nerve conduction study (NCS) have been reported, and there are many reports on the relationship between severity classifications and clinical symptoms. The existing electrophysiological severity classifications have several problems, such as cases that do not fit into a classification and unclear reasons for the boundary value. The purpose of this study was to clarify the relationship between sensory nerve conduction velocity (SCV) and distal motor latency (DML) and to evaluate whether the existing severity classification method is appropriate. We created a scatter diagram between SCV and DML for our NCSs and found a negative correlation between SCV and DML (correlation coefficient, −0.786). When we applied our NCSs to the existing classifications (Padua and Bland classifications), there were many unclassifiable cases (15.2%; Padua classification), and the number of Grade 3 cases was significantly higher than that of Grade 2 or 4 cases (Bland classification). Our large dataset revealed a strong negative correlation between SCV and DML, indicating that the existing severity classifications do not always accurately reflect the severity of the disease.

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“…Researchers have dedicated significant effort to determining the characteristics of NeuP in patients with carpal tunnel syndrome. Matesanz et al reported that the severity of NeuP is associated with more pronounced deficits in emotional well-being and sleep quality ( 3 ). Oteo-Alvaro and Marin revealed that numbness/tingling, pain intensity, and neurologic affectation are risk factors for NeuP ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study

Liu

Zhuang²,

Wei³

et al. 2022

Front. Surg.

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BackgroundThe aim of the study was to compare the clinical characteristics of diabetic carpal tunnel syndrome between patients with neuropathic pain (NeuP) and non-NeuP.MethodsWe enrolled 276 patients with diabetic carpal tunnel syndrome. Pain symptoms were evaluated using a visual analog scale. Douleur Neuropathique 4, the Neuropathic Pain Symptoms Inventory questionnaire, and the body map were used to assess neuropathic symptoms. Baseline information, clinical manifestations, electrophysiological test results, and psychological status were compared between the neuropathic pain (NeuP) and non-NeuP to identify the risk factor for NeuP occurrence.ResultsResults showed that the degree of pain was more severe in NeuP patients than in nociceptive pain patients (p = 0.025). The frequencies of light touch and pinprick were more pronounced in the NeuP group than in the non-NeuP group (light touch: p = 0.001; pinprick: p = 0.004). There were 48 and 27 NeuP patients with extramedian and proximal spread, respectively, whereas in the non-NeuP group, there were 11 and 9 patients, respectively (p = 0.03). Electrophysiological results showed that patients in the NeuP group exhibited greater sensory nerve conduction velocity impairment compared with the non-NeuP group (p = 0.033). Pain Catastrophizing Scale total scores of the NeuP group were significantly higher than those of the non-NeuP group (p = 0.006).ConclusionOf the 276 diabetic carpal tunnel syndrome patients studied, the majority had NeuP. Furthermore, light touch, electrophysiological test results, and psychological factors were found to be related to NeuP occurrence in patients with diabetic carpal tunnel syndrome.

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Somatosensory and psychological phenotypes associated with neuropathic pain in entrapment neuropathy

Abstract: Supplemental Digital Content is Available in the Text. The severity more than the presence of neuropathic pain is related to the extent of neuropathy and a compromise of emotional well-being in entrapment neuropathies.

Cited by 18 publications

References 59 publications

Signs Indicative of Central Sensitization Are Present but Not Associated with the Central Sensitization Inventory in Patients with Focal Nerve Injury

Signs Indicative of Central Sensitization Are Present but Not Associated with the Central Sensitization Inventory in Patients with Focal Nerve Injury

Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome

Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study

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