DOLORisk: study protocol for a multi-centre observational study to understand the risk factors and determinants of neuropathic pain

Pascal, Mathilde M.V.; Themistocleous, Andreas C.; Baron, Ralf; Binder, Andreas; Bouhassira, Didier; Crombez, Geert; Finnerup, Nanna Brix; Gierthmühlen, Janne; Granovsky, Yelena; Groop, Leif; Hébert, Harry L.; Jensen, Troels Staehelin; Johnsen, Kristinn; McCarthy, Mark I.; Wang, Meng; Palmer, Colin N.A.; Rice, Andrew S.C.; Serra, Jordi; Solà, Romà; Yarnitsky, David; Smith, Blair H.; Attal, Nadine; Bennett, David L.H.

doi:10.12688/wellcomeopenres.14576.2

Cited by 25 publications

(35 citation statements)

References 48 publications

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“…All patients underwent a neurological examination by a doctor, and the MNSI was used to evaluate neuropathy (2, 25). We used both sections A and B, as mentioned above.…”

Section: Methodsmentioning

confidence: 99%

“…It is still unknown why some sub-groups of patients with the same disease develop neuropathic pain; even in this sub-group, the severity and impact of pain in individuals with the same conditions (23) are variable and unpredictable. A plausible explanation for this variation in neuropathic pain prevalence and severity is a complex interaction among genetic, psychosocial, and clinical risk factors in a more susceptible patient (24, 25). The pain can either be spontaneous or be provoked by painless (allodynia) or painful (hyperalgesia) stimuli.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Determinants of Painful and Painless Neuropathy in Type 1 Diabetes Mellitus

et al. 2019

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Aims: To evaluate (1) the prevalence of diabetic distal symmetrical sensory–motor polyneuropathy (DSPN) and painful DSPN among patients with type 1 diabetes mellitus (DM1) aged over 18 years and (2) the determinant factors of neuropathy and pain in those patients. Materials and Methods: An epidemiological, cross-sectional, observational study was performed; 330,386 people were included, and a total of 444 people were diagnosed with DM1. After exclusion of possible confounders, 360 patients were assessed for painless and painful DSPNs using neurological examination and questionnaires for neuropathy and pain. Odds ratio (OR) and confidence intervals (95% CI) were estimated using multinomial logistic regression models. The analysis was based on a framework with four conceptual levels that consider feasible pathways between several risk factors: (1) socio-demographic factors and diabetes duration, (2) patient habits, (3) co-morbidities, and (4) metabolic factors and disease complications. Results: The prevalence of DSPN and painful DSPN were 42.8 and 18.9%, respectively. Diabetes duration was positively associated with painful (OR = 1.107, 95% CI: 1.107–1.139) and painless DSPN (OR = 1.069, 95% CI: 1.043–1.096). Education level was negatively associated with painful DSPN (OR = 0.889, 95% CI: 0.826–0.957). Sex (female) was positively associated only with painless DSPN (OR = 1.769, 95% CI: 1.007–3.107). Being a current or former smoker was positively associated only with painless DSPN (OR = 1.940, 95% CI: 1.069–3.518). Hypertension was positively associated with painful DSPN (OR = 2.474, 95% CI: 1.110–5.512) and painless DSPN (OR = 2.565, 95% CI: 1.252–5.256). Glycated hemoglobin (HbA1c) was positively associated only with painless DSPN (OR = 1.193, 95% CI: 1.018–1.399). Conclusions: Diabetes duration and hypertension have a direct impact on the development of painful and painless DSPN. However, female sex and HbA1c have a direct effect only on the development of painless DSPN, and education level has an indirect effect on the development of painful DSPN. Therefore, it can be concluded that different etiological factors have different contributions to the development of neuropathy and pain.

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“…All patients underwent a neurological examination by a doctor, and the MNSI was used to evaluate neuropathy (2, 25). We used both sections A and B, as mentioned above.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and Determinants of Painful and Painless Neuropathy in Type 1 Diabetes Mellitus

et al. 2019

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“…Whether or not patients develop NP seems to be a multifactorial interaction of psychosocial, genetic, biological, and clinical risk factors (Hebert et al 2017). A large (~ 10,000 participants), currently running multi-center observational study, DOLORisk, aims to elucidate these risk factors of development of NP (Pascal et al 2018).…”

Section: Etiologymentioning

confidence: 99%

Challenges of neuropathic pain: focus on diabetic neuropathy

et al. 2020

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Neuropathic pain is a frequent condition caused by a lesion or disease of the central or peripheral somatosensory nervous system. A frequent cause of peripheral neuropathic pain is diabetic neuropathy. Its complex pathophysiology is not yet fully elucidated, which contributes to underassessment and undertreatment. A mechanism-based treatment of painful diabetic neuropathy is challenging but phenotype-based stratification might be a way to develop individualized therapeutic concepts. Our goal is to review current knowledge of the pathophysiology of peripheral neuropathic pain, particularly painful diabetic neuropathy. We discuss state-of-the-art clinical assessment, validity of diagnostic and screening tools, and recommendations for the management of diabetic neuropathic pain including approaches towards personalized pain management. We also propose a research agenda for translational research including patient stratification for clinical trials and improved preclinical models in relation to current knowledge of underlying mechanisms.

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“…In terms of an explanation, this ethnic and racial disparity appears to involve biological, sociocultural, and environmental factors [ 105 ]. For all of these reasons, some authors recommend the development of tools to measure pain that are culturally appropriate [ 106 , 107 ].…”

Section: Discussionmentioning

confidence: 99%

Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?

Maiga¹,

Sangho

Konipo

et al. 2021

eNeurologicalSci

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Introduction According to the taxonomy of the International Association for the Study of Pain (IASP 2011), neuropathic pain (NeuP) is defined as “ pain caused by a lesion or disease of the somatosensory nervous system ”. NeuP is currently well-defined clinically, despite a high degree of etiological variation, and it has become a significant public health problem. This work aimed to study the situation regarding NeuP in current practice in Mali, as well as to analyze the therapeutic environment of the patients. Methodology This was a retrospective and cross-sectional study, carried out in two phases: (1) compilation of the files of patients according to the ICD-11, over a period of 24 months (2) a second prospective phase regarding the Knowledge, Attitudes, and Practices (KAP) of general practitioners and neurologists in regard to NeuP. The focus of the first phase of the study was the files of the patients who had undergone a consultation at the Gabriel Touré UHC. The second phase of the study focused on the general practitioners (Community Health Centers (comHC) of Bamako) and neurologists (Malian or not). Results Over the period of the study, 7840 patients were seen in consultation in the Department of Neurology, of whom 903 for NeuP, thus amounting to a NeuP frequency of 11.5%. Women accounted for 58.9% (532/903), with a sex ratio of 1.4. Using a comparative normal law, the difference in frequency was statistically significant between males and females ( p < 10 −7 ) and between two age groups (p 〈10 −3 ). The 49–58 years of age group was represented the most. Diabetic NeuP (21%), lumbar radiculopathies (14%), HIV/AIDS NeuP (13%), and post-stroke NeuP (11%) were the most represented. The survey among the carers revealed: a need for training, a low level of compliance with the therapeutic guidelines, and the use of traditional medicine by the patients. Discussion/conclusion This work confirms that NeuP is encountered frequently in current practice, and its optimal management will involve specific training of carers and improvement of access to the medications recommended in this indication. In light of this issue, we revisit the debate regarding the concept of essential medications and the relevance of taking into account effective medications for the treatment of NeuP.

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DOLORisk: study protocol for a multi-centre observational study to understand the risk factors and determinants of neuropathic pain

Cited by 25 publications

References 48 publications

Prevalence and Determinants of Painful and Painless Neuropathy in Type 1 Diabetes Mellitus

Prevalence and Determinants of Painful and Painless Neuropathy in Type 1 Diabetes Mellitus

Challenges of neuropathic pain: focus on diabetic neuropathy

Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?

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