Neuropathic pain and small fiber lesion: current state of the problem and the role of quantitative sensory testing in diagnosis

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Abstract

This article provides an overview of current knowledge about the pathophysiology of peripheral neuropathic pain, modern clinical assessment and the validity of diagnostic and screening tools.

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About the authors

A. A. Kunitskiy

Beloostrov Clinic of High Technologies

Author for correspondence.
Email: scvssd@yandex.ru
ORCID iD: 0009-0007-9966-0752
Russian Federation, Leningrad Region, Yukki urban settlement

O. G. Gutkina

Beloostrov Clinic of High Technologies

Email: scvssd@yandex.ru
Russian Federation, Leningrad Region, Yukki urban settlement

A. I. Skibro

Beloostrov Clinic of High Technologies

Email: scvssd@yandex.ru
Russian Federation, Leningrad Region, Yukki urban settlement

N. A. Kazakova

Beloostrov Clinic of High Technologies

Email: scvssd@yandex.ru
Russian Federation, Leningrad Region, Yukki urban settlement

Yu. V. Gaiduk

Beloostrov Clinic of High Technologies

Email: scvssd@yandex.ru

Candidate of Medical Sciences

Russian Federation, Leningrad Region, Yukki urban settlement

References

  1. Treede R.D., Rief W., Barke A. et al. Chronic pain as a symptom or a disease: the IASP Classifcation of Chronic Pain for the International Classifcation of Diseases (ICD-11). Pain. 2019; 160 (1): 19–27. doi: 10.1097/j.pain.0000000000001384
  2. IASP. Part III: Pain terms. A current list with defnitions and notes on usage. International Association for the Study of Pain (IASP). Pain terms. Proc Jpn Acad Ser B Phys Biol Sci. 2011; 93: 174–82. doi: 10.2183/pjab.93.011
  3. Freynhagen R., Parada H.A., Calderon-Ospina C.A. et al. Current understanding of the mixed pain concept: a brief narrative review. Curr Med Res Opin. 2019; 35 (6): 1011–8. doi: 10.1080/03007995.2018.1552042
  4. Attal N., Bouhassira D., Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. Lancet Neurol. 2018; 17 (5): 456–66. doi: 10.1016/S1474-4422(18)30071-1
  5. Nawroth P.P., Bendszus M., Pham M. et al. The quest for more research on painful diabetic neuropathy. Neuroscience. 2018; 387: 28–37. doi: 10.1016/j.neuroscience.2017.09.023
  6. Pascal M.M.V., Themistocleous A.C., Baron R. et al. DOLORisk: study protocol for a multi-centre observational study to understand the risk factors and determinants of neuropathic pain. Wellcome Open Res. 2019; 3: 63. doi: 10.12688/wellcomeopenres.14576.2
  7. Hameed S. Nav1.7 and Nav1.8: role in the pathophysiology of pain. Mol Pain. 2019; 15: 1744806919858801. doi: 10.1177/1744806919858801
  8. Chen J., Li L., Chen Sh.-R. et al. The alpha2delta-1-NMDA receptor complex is critically involved in neuropathic pain development and gabapentin therapeutic actions. Cell Rep. 2018; 22 (9): 2307–21. doi: 10.1016/j.celrep.2018.02.021
  9. Albrecht D.S., Ahmed Sh.U., Kettner N.W. et al. Neuroinfammation of the spinal cord and nerve roots in chronic radicular pain patients. Pain. 2018; 159 (5): 968–77. doi: 10.1097/j.pain.0000000000001171
  10. Ji R.R., Nackley A., Huh Y. et al. (2018) Neuroinfammation and central sensitization in chronic and widespread pain. Anesthesiology. 2018; 129 (2): 343–66. doi: 10.1097/aln.00000 00000002130
  11. Scholz J., Finnerup N.B., Attal N. et al. The IASP classifcation of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019; 160 (1): 53–9. doi: 10.1097/j.pain.0000000000001365
  12. Vollert J., Magerl W., Baron R. et al. Pathophysiological mechanisms of neuropathic pain: comparison of sensory phenotypes in patients and human surrogate pain models. Pain. 2018; 159 (6): 1090–102. doi: 10.1097/j.pain.0000000000001190
  13. Kopf S., Groener J.B., Kender Z. et al. Deep phenotyping neuropathy: an underestimated complication in patients with pre-diabetes and type 2 diabetes associated with albuminuria. Diabetes Res Clin Pract. 2018; 146: 191–201. doi: 10.1016/j.diabres.2018.10.020
  14. Timmerman H., Wilder-Smith O.H., Steegers M.A. et al. The added value of bedside examination and screening QST to improve neuropathic pain identifcation in patients with chronic pain. J Pain Res. 2018; 11: 1307–18. doi: 10.2147/JPR.S154698
  15. Feldman E.L., Callaghan B.C., Pop-Busui R. et al. Diabetic neuropathy. Nat Rev Dis Primers. 2019; 5 (1): 41. doi: 10.1038/s41572-019-0092-1
  16. Pop-Busui R., Boulton A.J.M., Feldman E.L. et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017; 40: 136–54. doi: 10.2337/dc16-2042
  17. Ponirakis G., Odriozolab M.N., Odriozola S. et al. NerveCheck: an inexpensive quantitative sensory testing device for patients with diabetic neuropathy. Diabetes Res Clin Pract. 2016; 113: 101–7. doi: 10.1016/j.diabres.2015.12.023
  18. Dyck P.J., Carter R.E., Litchy W.J. Modeling nerve conduction criteria for diagnosis of diabetic polyneuropathy. Muscle Nerve. 2011; 44: 340–5. doi: 10.1002/mus.22074
  19. Di Stefano G., La Cesa S., Leone C. et al. Diagnostic accuracy of laser-evoked potentials in diabetic neuropathy. Pain. 2017; 158: 1100–7. doi: 10.1097/j.pain.0000000000000889
  20. Leone C., Dufour A., Di Stefano G. et al Cooling the skin for assessing small-fibre function. Pain. 2019; 160: 1967–75. doi: 10.1097/j.pain.0000000000001584
  21. Krishnan S.T., Rayman G. The LDIflare: a novel test of C-fiber function demonstrates early neuropathy in type 2 diabetes. Diabetes Care. 2004; 27: 2930–5. doi: 10.2337/diacare.27.12.2930
  22. Alam U., Jeziorska M., Petropoulos I.N. et al. Diagnostic utility of corneal confocal microscopy and intra-epidermal nerve fibre density in diabetic neuropathy. PLoS One. 2017; 12 (7): e0180175. doi: 10.1371/journal.pone.0180175
  23. Quattrini C., Tavakoli M., Jeziorska M. et al. Surrogate markers of small fiber damage in human diabetic neuropathy. Diabetes. 2007; 56: 2148–54. doi: 10.2337/db07-0285
  24. Potockova V., Mala S., Hoskovcova L. et al. Thermal quantitative sensory testing as a screening tool for cardiac autonomic neuropathy in patients with diabetes mellitus. Brain Behav. 2022; 12 (3): e2506. doi: 10.1002/brb3.2506
  25. Guo S., Wang W., Huang H. et al. Quantitative sensory testing can effectively predict cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus. Acta Diabetol. 2021; 58 (11): 1541–9. doi: 10.1007/s00592-021-01744-4

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