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

Vollert, Jan; Kramer, Martin; Barroso, Alejandro; Freynhagen, Rainer; Haanpää, Maija; Hansson, Per; Jensen, Troels S.; Kuehler, Bianca M.; Maier, Christoph; Mainka, Tina; Reimer, Maren; Segerdahl, Märta; Serra, Jordi; Solà, Romà; Tölle, Thomas R.; Treede, Rolf-Detlef; Baron, Ralf

doi: 10.1097/j.pain.0000000000000588
Research Paper
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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.

Although not designed for this purpose, painDETECT Questionnaire items exhibit group differences between neuropathic pain patients with or without sensory loss.

aDepartment of Pain Medicine, BG University Hospital Bergmannsheil GmbH, Ruhr-University, Bochum, Germany

bCenter of Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany

cDepartment of Surgery and Cancer, Pain Research, Imperial College, London, United Kingdom

dPain Treatment Unit, Department of Anaesthesiology and Pain Therapy, Hospital Regional Universitario de Malaga, Malaga, Spain

eDepartment of Anaesthesiology, Critical Care Medicine, Pain Therapy & Palliative Care, Pain Center Lake Starnberg, Benedictus Hospital, Tutzing, Germany

fDepartment of Anaesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

gHelsinki University Central Hospital, Helsinki, Finland

hEtera Mutual Pension Insurance Company, Helsinki, Finland

iDepartment of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway

jDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

kDepartment of Neurology, Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark

lChelsea and Westminster Healthcare NHS Fdn Trust, London, United Kingdom

mDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

nDivision of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany

oH. Lundbeck A/S, Copenhagen, Denmark

pDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden

qNeuroscience Technologies, Ltd, Barcelona, Spain

rDepartment of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

Corresponding author. Address: Department of Pain Medicine, University Hospital Bergmannsheil Bochum GmbH, Bürkle de la Camp-Platz 1, Bochum 44789, Germany. Tel.: +49 234/302-6232; fax: +49 234/302-6367. E-mail address: Jan.Vollert@rub.de (J. Vollert).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received December 07, 2015

Received in revised form April 06, 2016

Accepted April 11, 2016

© 2016 International Association for the Study of Pain
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