Symptom profiles in the painDETECT Questionnaire in patients with peripheral neuropathic pain stratified according to sensory loss in quantitative sensory testing

Abstract

The painDETECT Questionnaire (PDQ) is commonly used as a screening tool to discriminate between neuropathic pain (NP) and nociceptive pain, based on the self-report of symptoms, including pain qualities, numbness, and pain to touch, cold, or heat. However, there are minimal data about whether the PDQ is differentially sensitive to different sensory phenotypes in NP. The aim of the study was to analyze whether the overall PDQ score or its items reflect phenotypes of sensory loss in NP as determined by quantitative sensory testing. An exploratory analysis in the Innovative Medicines Initiative Europain and Neuropain database was performed. Data records of 336 patients identified with NP were grouped into sensory profiles characterized by (1) no loss of sensation, (2) loss of thermal sensation, (3) loss of mechanical sensation, and (4) loss of thermal and mechanical sensation. painDETECT Questionnaire profiles were analyzed in a 2-factor analysis of variance. Patients with loss of thermal sensation (2 and 4) significantly more often reported pain evoked by light touch, and patients with loss of mechanical sensation (3 and 4) significantly more often reported numbness and significantly less often burning sensations and pain evoked by light touch. Although the PDQ was not designed to assess sensory loss, single items reflect thermal and/or mechanical sensory loss at group level, but because of substantial variability, the PDQ does not allow for individual allocation of patients into sensory profiles. It will be useful to develop screening tools according to the current definition of NP.

Pressure Pain Phenotypes in Women Before Breast Cancer Treatment

“…Contrary to published literature, this study did not find associations between pain sensitivity and age, race, cancer stage, anxiety, fatigue, sleep-wake disturbance, cognitive difficulty, childhood trauma experience, or widespread pain (El Tumi, Johnson, Dantas, Maynard, & Tashani, 2017;Tesarz, Eich, Treede, & Gerhardt, 2016;Vaegter & Graven-Nielsen, 2016). The evidence of associations between pain sensitivity and age, socioeconomic factors, and neuropathic pain presence and severity has been inconsistent and is inconclusive (El Tumi et al, 2017;Martinez et al, 2015;Vaegter & Graven-Nielsen, 2016;Vollert et al, 2016). Although evidence suggests that many symptoms share common central nervous system-mediated pathways and contribute to processes that increase pain sensitivity (Burnstock, 2015;Campbell et al, 2015;Clauw & Chrousos, 1997;Goesling, Clauw, & Hassett, 2013), the current study may have been unable to detect symptom associations found in prior studies because of the small sample size or low symptom severities in the presurgical sample.…”

“…Some studies in other chronic pain populations support the individualization of pain treatment based on QST indicators of abnormal pain-processing mechanisms (Rabey, Slater, O'Sullivan, Beales, & Smith, 2015;Vollert et al, 2016). Other literature suggests tailoring interventions based on genotype, self-reported symptom clusters, comorbidities, and pain severity and catastrophizing (Ahmedzai, 2013;Cherkin et al, 2016;Hill et al, 2011).…”

Characterizing the Somatosensory Profile of Patients With Failed Back Surgery Syndrome With Unilateral Lumbar Radiculopathy Undergoing Spinal Cord Stimulation: A Single Center Prospective Pilot Study

“…Currently there is a growing interest in characterizing the somatosensory profile of patients with chronic pain using both validated questionnaires and quantitative sensory testing (QST) . This may not only allow us to subgroup patients based on underlying mechanisms but also helps us to identify suitable targets for treatment and perhaps might help us differentiate responders from non‐responders .…”

Assessment and manifestation of central sensitisation across different chronic pain conditions

“…The painDETECT questionnaire has been developed as a neuropathic screening tool for assessing neuropathic components in chronic musculoskeletal pain, such as chronic LBP (Freynhagen et al, 2006) and OA (Hochman et al, 2013), but it is not specifically useful for neuropathic pain conditions with sensory loss (Vollert et al, 2016). More recently another mechanism-based classification questionnaire has been developed for LBP to identify symptoms and signs associated with a clinical classification of CS in patients with low back (AE leg) pain (Smart et al, 2012).…”