Diagnosis of neuropathic pain: challenges and possibilities

Lauria, Giuseppe; Faber, Catharina G.; Merkies, Ingemar S.J.; Waxman, Stephen G.

doi:10.1517/17530059.2012.661712

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…28,31 These questionnaires are validated and can be used as discriminative and descriptive instruments to screen patients, though their ability in diagnosing the different forms of pain in individual patients is arguable. 38 Moreover, pain perception is known to be strongly affected by attention, hypervigilance and context, 39 all of which can variably influence the experience of pain and, therefore, how pain is recorded and to what degree it interferes with life.…”

Section: Assessment Of Pain In the Clinical Settingmentioning

confidence: 99%

Pain in amyotrophic lateral sclerosis

Chiò

Mora

Lauria

2017

The Lancet Neurology

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114

113

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Pain is a largely neglected symptom in amyotrophic lateral sclerosis (ALS) although reported in a majority of patients. It occurs at all stages of the disease and can be an onset symptom preceding motor dysfunction. Pain is correlated with a deterioration of the patient's quality of life and increased depression. In the later stages of ALS, the pain severity can be such as to require increasing use of sedative-analgesic drugs and is among the events predicting clinical deterioration and death. The site of pain depends on the pain type or underlying mechanism, i.e. painful cramps (lower limbs, hands), nociceptive pain (shoulders, joints, pressure sores) or neuropathic pain (feet, lower limbs). Given the multifactorial nature of pain in ALS, different treatments have been suggested, ranging from non-steroidal anti-inflammatory agents, drugs for neuropathic pain, opioids and, most recently, cannabinoids, to physical therapy strategies and preventive assistive devices. Further understanding of the pathophysiology is crucial to drive assessment in clinical trials of therapeutic strategies targeted at specific mechanisms and studies of individually tailored therapies.

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Section: Assessment Of Pain In the Clinical Settingmentioning

confidence: 99%

Pain in amyotrophic lateral sclerosis

Chiò

Mora

Lauria

2017

The Lancet Neurology

Self Cite

114

113

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“…Furthermore, it does not distinguish well between neuropathic pain and nociceptive pain (Vranken, 2012). Recently, a new precise definition of neuropathic pain has been put forward to avoid the above shortcomings, and to further beneficially support clinical and research purposes (Lauria et al, 2012; Treede et al, 2019). The revised definition is that “pain arose as a direct consequence of a lesion or disease affecting the somatosensory system,” which definitely indicates that the peripheral or central somatosensory system must be involved (Scholz et al, 2019; Treede et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Emerging Roles of Long Non-coding RNAs in Chronic Neuropathic Pain

Wu¹,

Ji²,

Zhao³

2019

Front. Neurosci.

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Chronic neuropathic pain, a type of chronic and potentially disabling pain caused by a disease or injury of the somatosensory nervous system, spinal cord injury, or various chronic conditions, such as viral infections (e.g., post-herpetic neuralgia), autoimmune diseases, cancers, and metabolic disorders (e.g., diabetes mellitus), is one of the most intense types of chronic pain, which incurs a major socioeconomic burden and is a serious public health issue, with an estimated prevalence of 7-10% in adults throughout the world. Presently, the available drug treatments (e.g., anticonvulsants acting at calcium channels, serotonin-noradrenaline reuptake inhibitors, tricyclic antidepressants, opioids, topical lidocaine, etc.) for chronic neuropathic pain patients are still rare and have disappointing efficacy, which makes it difficult to relieve the patients' painful symptoms, and, at best, they only try to reduce the patients' ability to tolerate pain. Long non-coding RNAs (lncRNAs), a type of transcript of more than 200 nucleotides with no protein-coding or limited capacity, were identified to be abnormally expressed in the spinal cord, dorsal root ganglion, hippocampus, and prefrontal cortex under chronic neuropathic pain conditions. Moreover, a rapidly growing body of data has clearly pointed out that nearly 40% of lncRNAs exist specifically in the nervous system. Hence, it was speculated that these dysregulated lncRNAs might participate in the occurrence, development, and progression of chronic neuropathic pain. In other words, if we deeply delve into the potential roles of lncRNAs in the pathogenesis of chronic neuropathic pain, this may open up new strategies and directions for the development of novel targeted drugs to cure this refractory disorder. In this article, we primarily review the status of chronic neuropathic pain and provide a general overview of lncRNAs, the detailed roles of lncRNAs in the nervous system and its related diseases, and the abnormal expression of lncRNAs and their potential clinical applications in chronic neuropathic pain. We hope that through the above description, readers can gain a better understanding of the emerging roles of lncRNAs in chronic neuropathic pain.

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“…Symptoms alone do not allow a mechanism-based stratification of neuropathic pain patients [2] to enable the development of tailored analgesic treatments. Indeed, studies focused on descriptive tools (e.g., Neuropathic Pain Symptom Inventory) [3,4] or quantitative sensory testing [5] have failed to correlate pain features to the etiology or even the localization of the neurological damage.…”

Section: Introductionmentioning

confidence: 99%

The Role of Sodium Channels in Painful Diabetic and Idiopathic Neuropathy

et al. 2014

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Painful neuropathies are frequently encountered in clinical practice as an early or late complication of several systemic disorders. Among them, diabetes is one of the most important due to its epidemiology and the relevance for regulatory agencies in the assessment of efficacy of new analgesics. However, the presentation and course of painful neuropathies, as well as the response to available drugs, are highly variable and unpredictable, posing significant challenges in the management of patients. Experimental and clinical studies have suggested that polymorphisms and mutations in pain-related genes are involved in the facilitation or inhibition of nociception, and might modulate neuropathic pain and the response to analgesics in patients. Voltage-gated sodium channel genes are among the most relevant, due to the key role of these membrane proteins in the physiology of nociception and their involvement in the pathogenesis of idiopathic painful small fiber neuropathies. These compelling features make sodium channel candidate targets for a novel approach to painful diabetic and idiopathic neuropathies, which will hopefully allow a new classification of patients and more effective targeted treatments.

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Diagnosis of neuropathic pain: challenges and possibilities

Cited by 9 publications

References 28 publications

Pain in amyotrophic lateral sclerosis

Pain in amyotrophic lateral sclerosis

Emerging Roles of Long Non-coding RNAs in Chronic Neuropathic Pain

The Role of Sodium Channels in Painful Diabetic and Idiopathic Neuropathy

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