Detailed Information on Publication Record
2022
Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain
RAPUTOVÁ, Jana, Aneta RAJDOVÁ, Jan VOLLERT, Iva ŠROTOVÁ, Cora REBHORN et. al.Basic information
Original name
Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain
Authors
RAPUTOVÁ, Jana (203 Czech Republic, belonging to the institution), Aneta RAJDOVÁ (203 Czech Republic, belonging to the institution), Jan VOLLERT, Iva ŠROTOVÁ (203 Czech Republic, belonging to the institution), Cora REBHORN, Nurcan UECEYLER, Frank BIRKLEIN, Claudia SOMMER, Eva VLČKOVÁ (203 Czech Republic, belonging to the institution) and Josef BEDNAŘÍK (203 Czech Republic, guarantor, belonging to the institution)
Edition
European Journal of Pain, Amsterdam, Elsevier, 2022, 1090-3801
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30210 Clinical neurology
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 3.600
RIV identification code
RIV/00216224:14110/22:00127722
Organization unit
Faculty of Medicine
UT WoS
000854563100001
Keywords in English
diabetes mellitus patients; sensory profiles; neuropathy; pain
Tags
International impact, Reviewed
Změněno: 5/1/2023 13:42, Mgr. Tereza Miškechová
Abstract
V originále
Background Quantitative sensory testing (QST) assesses the functional integrity of small and large nerve fibre afferents and central somatosensory pathways; QST was assumed to provide insight into the mechanisms of neuropathy. We analysed QST profiles and phenotypes in patients with diabetes mellitus to study whether these could differentiate patients with and without pain and neuropathy. Methods A standardized QST protocol was performed and 'loss and gain of function' abnormalities were analysed in four groups of subjects: diabetic patients with painful (pDSPN; n = 220) and non-painful distal symmetric polyneuropathy (nDSPN; n = 219), diabetic patients without neuropathy (DM; n = 23) and healthy non-diabetic subjects (n = 37). Based on the QST findings, diabetic subjects were further stratified into four predefined prototypic phenotypes: sensory loss (SL), thermal hyperalgesia (TH), mechanical hyperalgesia (MH) and healthy individuals. Results Patients in the pDSPN group showed the greatest hyposensitivity ('loss of function'), and DM patients showed the lowest, with statistically significant increases in thermal, thermal pain, mechanical and mechanical pain sensory thresholds. Accordingly, the frequency of the SL phenotype was significantly higher in the pDSPN subgroup (41.8%), than expected (p < 0.0042). The proportion of 'gain of function' abnormalities was low in both pDSPN and nDSPN patients without significant differences. Conclusions There is a continuum in the sensory profiles of diabetic patients, with a more pronounced sensory loss in pDSPN group probably reflecting somatosensory nerve fibre degeneration. An analysis of 'gain of function' abnormalities (allodynia, hyperalgesia) did not offer a key to understanding the pathophysiology of spontaneous diabetic peripheral neuropathic pain. Significance This article, using quantitative sensory testing profiles in large cohorts of diabetic patients with and without polyneuropathy and pain, presents a continuum in the sensory profiles of diabetic patients, with more pronounced 'loss of function' abnormalities in painful polyneuropathy patients. Painful diabetic polyneuropathy probably represents a 'more progressed' type of neuropathy with more pronounced somatosensory nerve fibre degeneration. The proportion of 'gain of function' sensory abnormalities was low, and these offer limited understanding of pathophysiological mechanisms of spontaneous neuropathic pain.
Links
| ED1.1.00/02.0068, research and development project |
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| MUNI/A/1144/2021, interní kód MU |
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