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@article{2243747,
author = {Raputová, Jana and Rajdová, Aneta and Vollert, Jan and Šrotová, Iva and Rebhorn, Cora and Ueceyler, Nurcan and Birklein, Frank and Sommer, Claudia and Vlčková, Eva and Bednařík, Josef},
article_location = {Amsterdam},
article_number = {10},
doi = {http://dx.doi.org/10.1002/ejp.2034},
keywords = {diabetes mellitus patients; sensory profiles; neuropathy; pain},
language = {eng},
issn = {1090-3801},
journal = {European Journal of Pain},
title = {Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain},
url = {https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2034},
volume = {26},
year = {2022}
}
TY - JOUR
ID - 2243747
AU - Raputová, Jana - Rajdová, Aneta - Vollert, Jan - Šrotová, Iva - Rebhorn, Cora - Ueceyler, Nurcan - Birklein, Frank - Sommer, Claudia - Vlčková, Eva - Bednařík, Josef
PY - 2022
TI - Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain
JF - European Journal of Pain
VL - 26
IS - 10
SP - 2198-2212
EP - 2198-2212
PB - Elsevier
SN - 10903801
KW - diabetes mellitus patients
KW - sensory profiles
KW - neuropathy
KW - pain
UR - https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2034
N2 - 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.
ER -
RAPUTOVÁ, Jana, Aneta RAJDOVÁ, Jan VOLLERT, Iva ŠROTOVÁ, Cora REBHORN, Nurcan UECEYLER, Frank BIRKLEIN, Claudia SOMMER, Eva VLČKOVÁ and Josef BEDNAŘÍK. Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain. \textit{European Journal of Pain}. Amsterdam: Elsevier, 2022, vol.~26, No~10, p.~2198-2212. ISSN~1090-3801. Available from: https://dx.doi.org/10.1002/ejp.2034.
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