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Randomized Controlled Trial
. 2014 Feb;155(2):367-376.
doi: 10.1016/j.pain.2013.10.023. Epub 2013 Oct 25.

Sensory profiles of patients with neuropathic pain based on the neuropathic pain symptoms and signs

Roy Freeman  1 , Ralf Baron, Didier Bouhassira, Javier Cabrera, Birol Emir
Affiliations
Randomized Controlled Trial

Sensory profiles of patients with neuropathic pain based on the neuropathic pain symptoms and signs

Roy Freeman et al. Pain. 2014 Feb.

Abstract

This manuscript aimed to characterize the clinical profile of various neuropathic pain (NeP) disorders and to identify whether patterns of sensory symptoms/signs exist, based on baseline responses on the Neuropathic Pain Symptom Inventory (NPSI) questionnaire and the quantitative sensory testing (QST). These post hoc analyses were based on data from 4 randomized, double-blind, placebo-controlled clinical studies of pregabalin (150-600mg/day) in patients with NeP syndromes: central poststroke pain, posttraumatic peripheral pain, painful HIV neuropathy, and painful diabetic peripheral neuropathy. The NPSI questionnaire includes 10 different pain symptom descriptors. QST was used to detect sensory thresholds of accurately calibrated sensory stimuli and to quantify the intensity of evoked sensation. To identify symptoms/signs clusters and select the number of clusters, a principal component analysis (PCA) and hierarchical clustering methods with clinical input were used. Analysis of the NPSI pain qualities and individual QST measures at baseline indicated no clear association between particular symptoms/signs profiles and etiologies. Based on NPSI symptoms, PCA identified 3 pain dimensions: provoked, deep, and pinpoint. A hierarchical cluster analysis identified 3 clusters with distinct pain characteristics profiles independent of NeP syndrome. Based on QST signs, PCA identified 2 pain dimensions: evoked by cold and evoked by touch. A hierarchical cluster analysis identified 4 clusters with distinct pain characteristics profiles. These "trans-etiological" profiles may reflect distinct pathophysiological mechanisms and therefore, potential differential responses to treatment.

Keywords: Allodynia; Cluster analysis; Evoked pain; Hyperalgesia; NPSI; QST.

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