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Neuropathic Pain: From Prevention to Diagnosis and Treatment
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Neuropathic Pain: From Prevention to Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (15 February 2023) | Viewed by 22875

Special Issue Editors

Dr. Athina Vadalouca

E-Mail Website
Guest Editor
1. Hellenic Society of Pain Management and Palliative Care (PARH.SY.A.), Athens, Greece
2. Pain and Palliative Care Center, Athens Medical Center, Private Hospital, Athens, Greece
Interests: pain management; chronic pain; palliative medicine; pain perception; pain measurement
Dr. Panagiotis Zis

E-Mail Website
Guest Editor
1. Second Department of Neurology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
2. Medical School, University of Cyprus, Nicosia 1678, Cyprus
Interests: peripheral neuropathy; neuropathic pain; clinical neurophysiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pain is a complex somatic and emotional phenomenon. Causes of pain are numerous and include traumas, medical diseases, and genetic disorders. The universality of pain as a human experience and the high prevalence  of pain underscore the significance of this symptom, while its  complexity attracts significant attention from the research community to fully comprehend this experience. Neuropathic pain has a detrimental negative impact on the overall quality of life of pain sufferers and its effective management is crucial.  In this Special Issue we welcome original  papers, reviews and meta-analyses in all aspects of neuropathic pain,  from prevention to diagnosis and treatment.

Dr. Athina Vadalouca
Dr. Panagiotis Zis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuropathic pain
  • treatment
  • management
  • neuropathy
  • prevention

Published Papers (6 papers)

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Research

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13 pages, 1883 KiB  
Article
Acupuncture in Patients with Diabetic Peripheral Neuropathy-Related Complaints: A Randomized Controlled Clinical Trial
by Joanna Dietzel, Isabel V. Habermann, Sebastian Hörder, Katrin Hahn, Gesa Meyer-Hamme, Miriam Ortiz, Kevin Hua, Barbara Stöckigt, Marie Bolster, Weronika Grabowska, Stephanie Roll, Sylvia Binting, Stefan N. Willich, Sven Schröder and Benno Brinkhaus
J. Clin. Med. 2023, 12(6), 2103; https://doi.org/10.3390/jcm12062103 - 07 Mar 2023
Cited by 5 | Viewed by 4747
Abstract
Background: Diabetic polyneuropathy (DPN) is a common complication of diabetes, which presents with a loss of sensorimotor function or pain. This study assessed the effectiveness and safety of acupuncture as a treatment for DPN-related complaints. Methods: In this randomized controlled trial, [...] Read more.
Background: Diabetic polyneuropathy (DPN) is a common complication of diabetes, which presents with a loss of sensorimotor function or pain. This study assessed the effectiveness and safety of acupuncture as a treatment for DPN-related complaints. Methods: In this randomized controlled trial, patients with type II diabetes and symptoms of neuropathy in the lower limbs were included. A total of 12 acupuncture treatments were administered over 8 weeks. The waitlist control group received the same acupuncture treatment starting at week 16 (after baseline). Results: A total of 62 patients were randomized (acupuncture group n = 31; control group n = 31). The primary outcome was overall complaints, and it was reduced with a significant difference of 24.7 on a VAS (CI 95% 14.8;34.7, p < 0.001) between both groups in favor of acupuncture. Reductions were recorded for the secondary outcomes VAS pain, neuropathic pain symptom inventory (NPSI), emotional dimensions of pain, SF-12, and diabetic peripheral neuropathic pain impact (DPNPI) after the intervention and at the follow-ups in the acupuncture group. Adverse reactions were minor and transient. Conclusions: Acupuncture leads to a significant and lasting reduction in DPN-related complaints when compared to routine care and is well tolerated, with minor side effects. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)
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14 pages, 3210 KiB  
Article
Evaluation of (R)-[11C]PK11195 PET/MRI for Spinal Cord-Related Neuropathic Pain in Patients with Cervical Spinal Disorders
by Makoto Kitade, Hideaki Nakajima, Tetsuya Tsujikawa, Sakon Noriki, Tetsuya Mori, Yasushi Kiyono, Hidehiko Okazawa and Akihiko Matsumine
J. Clin. Med. 2023, 12(1), 116; https://doi.org/10.3390/jcm12010116 - 23 Dec 2022
Cited by 3 | Viewed by 1372
Abstract
Activated microglia are involved in secondary injury after acute spinal cord injury (SCI) and in development of spinal cord-related neuropathic pain (NeP). The aim of the study was to assess expression of translocator protein 18 kDa (TSPO) as an indicator of microglial activation [...] Read more.
Activated microglia are involved in secondary injury after acute spinal cord injury (SCI) and in development of spinal cord-related neuropathic pain (NeP). The aim of the study was to assess expression of translocator protein 18 kDa (TSPO) as an indicator of microglial activation and to investigate visualization of the dynamics of activated microglia in the injured spinal cord using PET imaging with (R)-[11C]PK11195, a specific ligand for TSPO. In SCI chimeric animal models, TSPO was expressed mainly in activated microglia. Accumulation of (R)-[3H]PK11195 was confirmed in autoradiography and its dynamics in the injured spinal cord were visualized by (R)-[11C]PK11195 PET imaging in the acute phase after SCI. In clinical application of (R)-[11C]PK11195 PET/MRI of the cervical spinal cord in patients with NeP related to cervical disorders, uptake was found in cases up to 10 months after injury or surgery. No uptake could be visualized in the injured spinal cord in patients with chronic NeP at more than 1 year after injury or surgery, regardless of the degree of NeP. However, a positive correlation was found between standardized uptake value ratio and the severity of NeP, suggesting the potential of clinical application for objective evaluation of chronic NeP. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)
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9 pages, 262 KiB  
Article
Are Anxiety and Depression Taking Sides with Knee-Pain in Osteoarthritis?
by Matthias Vogel, Marius Binneböse, Christoph H. Lohmann, Florian Junne, Alexander Berth and Christian Riediger
J. Clin. Med. 2022, 11(4), 1094; https://doi.org/10.3390/jcm11041094 - 18 Feb 2022
Cited by 2 | Viewed by 2884
Abstract
Introduction: Total knee arthroplasty (TKA) bears a potential of rendering patients unsatisfied with the operation as a result of negative affectivity related to osteoarthritis and TKA. Not only is pain a lateralized experience, but negative affect and other psychosomatic correlates of pain might [...] Read more.
Introduction: Total knee arthroplasty (TKA) bears a potential of rendering patients unsatisfied with the operation as a result of negative affectivity related to osteoarthritis and TKA. Not only is pain a lateralized experience, but negative affect and other psychosomatic correlates of pain might also be processed on grounds of lateralization. Lateralization in this context is likely linked to the amygdalae, which display differential left/right patterns of association with psychopathology. What is noteworthy is that osteoarthritis itself is linked not only to negative effects but also to childhood abuse. Method: The present study tests lateralization of psychosomatic correlates of knee-pain using the brief symptom inventory-18 (BSI-18), the dissociative experiences scale (FDS-20), the pain catastrophizing scale (PCS), the Tampa scale of kinesiophobia (TSK), the childhood trauma screener (CTS) and WOMAC. More precisely, we were interested in predicting the side of operations by means of the above-mentioned constructs using binary logistic regression, based on 150 participants (78 left knees) awaiting TKA for knee-osteoarthritis. Results: Somatization (p = 0.003), childhood abuse (p = 0.04) and pain-catastrophizing (p = 0.04) predicted operations on the right side. Anxiety (p = 0.001) and kinesiophobia (p = 0.002) predicted operations on the left side. Conclusions: Knee-pain may be differentially modulated by its psychosomatic correlates as a result of lateralization and corresponding patterns of psychosomatic reagibility. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)

Review

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26 pages, 2258 KiB  
Review
Novel Therapies for the Treatment of Neuropathic Pain: Potential and Pitfalls
by Pottathil Shinu, Mohamed A. Morsy, Anroop B. Nair, Abdulaziz K. Al Mouslem, Katharigatta N. Venugopala, Manoj Goyal, Monika Bansal, Shery Jacob and Pran Kishore Deb
J. Clin. Med. 2022, 11(11), 3002; https://doi.org/10.3390/jcm11113002 - 26 May 2022
Cited by 19 | Viewed by 7419
Abstract
Neuropathic pain affects more than one million people across the globe. The quality of life of people suffering from neuropathic pain has been considerably declining due to the unavailability of appropriate therapeutics. Currently, available treatment options can only treat patients symptomatically, but they [...] Read more.
Neuropathic pain affects more than one million people across the globe. The quality of life of people suffering from neuropathic pain has been considerably declining due to the unavailability of appropriate therapeutics. Currently, available treatment options can only treat patients symptomatically, but they are associated with severe adverse side effects and the development of tolerance over prolonged use. In the past decade, researchers were able to gain a better understanding of the mechanisms involved in neuropathic pain; thus, continuous efforts are evident, aiming to develop novel interventions with better efficacy instead of symptomatic treatment. The current review discusses the latest interventional strategies used in the treatment and management of neuropathic pain. This review also provides insights into the present scenario of pain research, particularly various interventional techniques such as spinal cord stimulation, steroid injection, neural blockade, transcranial/epidural stimulation, deep brain stimulation, percutaneous electrical nerve stimulation, neuroablative procedures, opto/chemogenetics, gene therapy, etc. In a nutshell, most of the above techniques are at preclinical stage and facing difficulty in translation to clinical studies due to the non-availability of appropriate methodologies. Therefore, continuing research on these interventional strategies may help in the development of promising novel therapies that can improve the quality of life of patients suffering from neuropathic pain. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)
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Other

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13 pages, 1294 KiB  
Systematic Review
Use of Electroneuromyography in the Diagnosis of Neurogenic Thoracic Outlet Syndrome: A Systematic Review and Meta-Analysis
by Pauline Daley, Germain Pomares, Raphael Gross, Pierre Menu, Marc Dauty and Alban Fouasson-Chailloux
J. Clin. Med. 2022, 11(17), 5206; https://doi.org/10.3390/jcm11175206 - 02 Sep 2022
Cited by 7 | Viewed by 2063
Abstract
Neurogenic thoracic outlet syndrome (NTOS) is a disabling condition. Its diagnosis remains challenging and is mainly guided by examination. Yet, electrophysiological evaluations are the gold standard for diagnosis of entrapment syndromes. We aimed to assess the interest of electrophysiological evaluation to diagnose NTOS. [...] Read more.
Neurogenic thoracic outlet syndrome (NTOS) is a disabling condition. Its diagnosis remains challenging and is mainly guided by examination. Yet, electrophysiological evaluations are the gold standard for diagnosis of entrapment syndromes. We aimed to assess the interest of electrophysiological evaluation to diagnose NTOS. A systematic literature research was performed using PubMed, ScienceDirect, Embase, Cochrane and Google Scholar databases to collect studies reporting results of electrophysiological assessment of patients with NTOS. Then, a meta-analysis was conducted. Nine studies were eligible and concerned two hundred and thirteen patients. Results were heterogenous among studies and the quality of evidence was very low to moderate. Data could not evaluate sensitivity or specificity of electrophysiological evaluations for NTOS. The meta-analysis found significantly decreased amplitudes of medial antebrachial cutaneous nerve SNAP (sensory nerve action potential), ulnar SNAP, median CMAP (compound motor action potential) and ulnar CMAP. Needle examination found abnormalities for the abductor pollicis brevis, first dorsal interosseous and adductor digiti minimi. Unlike most upper-limb entrapment syndromes, nerve conduction assessment only provided clues in favour of NTOS. Decreased amplitude for ulnar SNAP, medial antebrachial cutaneous SNAP, median CMAP and ulnar CMAP should be assessed, as well as needle examination. Larger studies are needed to evaluate the sensitivity and specificity of electrophysiology in NTOS diagnosis. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)
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14 pages, 736 KiB  
Systematic Review
Pharmacological Management of Neuropathic Pain after Radiotherapy in Head and Neck Cancer Patients: A Systematic Review
by Maria Kouri, Martina Rekatsina, Athina Vadalouca, Ioanna Siafaka, Emmanouil Vardas, Erofili Papadopoulou, Antonella Paladini and Giustino Varrassi
J. Clin. Med. 2022, 11(16), 4877; https://doi.org/10.3390/jcm11164877 - 19 Aug 2022
Cited by 6 | Viewed by 3314
Abstract
Background: Neuropathic pain (NP) in head and neck cancer (HNC) patients represents a treatment challenge. Most studies investigating drugs against NP are conducted in patients suffering with diabetic neuropathy or postherpetic neuralgia, while data are limited in cancer pain management. Additionally, regarding cancer [...] Read more.
Background: Neuropathic pain (NP) in head and neck cancer (HNC) patients represents a treatment challenge. Most studies investigating drugs against NP are conducted in patients suffering with diabetic neuropathy or postherpetic neuralgia, while data are limited in cancer pain management. Additionally, regarding cancer therapy-related NP, most of the studies do not focus on HNC patients. The aim of this review is to identify the studies on systematically administered medication for NP management that included HNC patients under radiotherapy. Methods: A systematic literature search was performed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in PubMed, Cochrane Library, Web of Science and ClinicalTrials.gov on 30 October 2021. The medical subject heading (MeSH) terms were (“head and neck cancer” OR “tumor”) AND “neuropathic pain” AND “medication” AND “radiotherapy.” The Cochrane Collaboration tool was used for quality assessment. Results: The search identified 432 articles. Three more articles were identified after searching the reference lists of the retrieved articles. A total of 10 articles met the eligibility inclusion criteria and were included in this review; 6 on gabapentin, 1 on pregabalin, 1 on nortriptyline, 1 on methadone, and 1 on ketamine. Statistically significant results in pain reduction compared to placebo or standard pain medication were found in the studies on pregabalin (p = 0.003), methadone (p = 0.03), ketamine (p = 0.012), and in two out of six gabapentin studies (p < 0.004). Two of the studies (both concerning gabapentin) had no comparison arm. Conclusions: Treatments including pregabalin, methadone, ketamine, and gabapentin were found to provide pain relief against HNC NP. While there is a plethora of pharmacological treatments available for the management of NP, only a few studies have been conducted regarding the pharmacological management of therapy-related NP in HNC patients. More studies should be conducted regarding the pharmacological approaches in HNC therapy-related NP so that specific treatment algorithms can be developed. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Prevention to Diagnosis and Treatment)
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