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Diagnostics
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Neuropathic Pain: Correct Diagnosis for Correct Management
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Neuropathic Pain: Correct Diagnosis for Correct Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 26585

Special Issue Editor

Dr. Daniele Coraci

E-Mail Website
Guest Editor
Department of Neuroscience, Section of Rehabilitation, University of Padova, 35121 Padua, Italy
Interests: ultrasound imaging; neurological diseases; diagnostic imaging; neurophysiology; ultrasonography; neurology; neuroimaging; movement analysis; trauma; clinical neurology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pain is the most common symptom reported by patients.  A particular species of pain is the neuropathic type: a debilitating condition, affecting the quality of life with different levels of severity. When this condition is present, the perception of physical and mental wellness can be harshly compromised. The patients’ quality of life may be significantly reduced with substantial impairments in every aspect of their personal and social lives. The complexity of the origin and the modifying factors are known. Furthermore, several situations may cause this condition. For these reasons, extensive knowledge of the mechanisms of neuropathic pain and the correct diagnosis is fundamental to proper patient management. Specific treatments, based on drugs and habits, represent effective tools. Additionally, rehabilitation, with its variety of approaches (physical agents, physiotherapy, education, etc.) is fundamental to restoring patient health.

This Special Issue is focused on the following aims:

  • The evaluation of the evidence related to the diagnostic tools of neuropathic pain;
  • The evaluation of new diagnostic methods for the assessment of neuropathic pain (neurophysiological, radiological, patient-oriented, etc.);
  • An overview of the different conditions that cause neuropathic pain;
  • An assessment of the effects of specific drugs on symptom reduction and quality of life;
  • The development of detailed rehabilitative programs for neuropathic pain;
  • The development of personalized protocols for patient management;
  • The analysis of proper outcome measures.

Dr. Daniele Coraci
Guest Editor

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. Diagnostics 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

  • pain
  • neuropathic pain
  • diagnosis
  • management
  • prognosis
  • treatment
  • therapy
  • rehabilitation
  • drug
  • nerve
  • neuropathy
  • neurophysiology
  • imaging
  • outcome measures
  • quality of life

Published Papers (6 papers)

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Research

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12 pages, 275 KiB  
Article
Is Neuropathic Pain a Good Marker of Peripheral Neuropathy in Hospice Patients with Advanced Cancer? The Single Center Pilot Study
by Joanna Drat-Gzubicka, Anna Pyszora, Jacek Budzyński, David Currow and Małgorzata Krajnik
Diagnostics 2021, 11(8), 1377; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081377 - 30 Jul 2021
Cited by 2 | Viewed by 1371
Abstract
Neuropathic pain (NP) affects approximately 30% of patients with advanced cancer. The prevalence of neuropathic pain related to peripheral neuropathy (NP-RPN) in these patients is not known. The aim of the study was to evaluate NP-RPN prevalence in hospice patients and to find [...] Read more.
Neuropathic pain (NP) affects approximately 30% of patients with advanced cancer. The prevalence of neuropathic pain related to peripheral neuropathy (NP-RPN) in these patients is not known. The aim of the study was to evaluate NP-RPN prevalence in hospice patients and to find out whether the absence of this pain is sufficient to rule out peripheral neuropathy. The study included a total of 76 patients with advanced cancer who were cared for at inpatient hospices. All patients were asked about shooting or burning pain (of the feet and hands), were examined systematically for sensory deficits and had a nerve conduction study performed. NP-RPN was found in 29% of the patients. Electrophysiologically-diagnosed peripheral neuropathy was found in 79% of patients, and the diagnostic electrophysiological criteria for neuropathy were met by one half of the patients without NP-RPN. The severity of NP-RPN was correlated with the clinically assessed severity of sensory neuropathy and the Karnofsky score, but was not correlated with the intensity of the clinical signs of motor neuropathy. The presence of NP-RPN did not reflect greater prevalence of motor and sensory abnormalities in neurological and electrophysiological examinations. The absence of NP-RPN did not rule out polyneuropathy in hospice patients. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)

Review

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19 pages, 334 KiB  
Review
Neuropathic Pain in the Elderly
by Silvia Giovannini, Daniele Coraci, Fabrizio Brau, Vincenzo Galluzzo, Claudia Loreti, Pietro Caliandro, Luca Padua, Giulio Maccauro, Lorenzo Biscotti and Roberto Bernabei
Diagnostics 2021, 11(4), 613; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11040613 - 30 Mar 2021
Cited by 41 | Viewed by 4931
Abstract
Neuropathic pain due to a lesion or a disease of the somatosensory system often affects older people presenting several comorbidities. Moreover, elderly patients are often poly-medicated, hospitalized and treated in a nursing home with a growing risk of drug interaction and recurrent hospitalization. [...] Read more.
Neuropathic pain due to a lesion or a disease of the somatosensory system often affects older people presenting several comorbidities. Moreover, elderly patients are often poly-medicated, hospitalized and treated in a nursing home with a growing risk of drug interaction and recurrent hospitalization. Neuropathic pain in the elderly has to be managed by a multidimensional approach that involves several medical, social and psychological professionals in order to improve the quality of life of the patients and, where present, their relatives. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)
10 pages, 876 KiB  
Review
Neuropathic Pain and Rehabilitation: A Systematic Review of International Guidelines
by Andrea Bernetti, Francesco Agostini, Alessandro de Sire, Massimiliano Mangone, Lucrezia Tognolo, Annalisa Di Cesare, Pierangela Ruiu, Teresa Paolucci, Marco Invernizzi and Marco Paoloni
Diagnostics 2021, 11(1), 74; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11010074 - 05 Jan 2021
Cited by 49 | Viewed by 8806
Abstract
Background: Neuropathic pain is an injury or disease of the central and/or peripheral somatosensory nervous system, and it has a significant impact on quality of life, especially since it is often refractory to treatment. Rehabilitative intervention is considered in various guidelines on neuropathic [...] Read more.
Background: Neuropathic pain is an injury or disease of the central and/or peripheral somatosensory nervous system, and it has a significant impact on quality of life, especially since it is often refractory to treatment. Rehabilitative intervention is considered in various guidelines on neuropathic pain treatment, although not in an organic nor detailed way. The aim of this systematic review was to analyze the most indicated therapeutic strategies, providing rehabilitative recommendations in the management of neuropathic pain. Methods: A systematic review was performed according to PRISMA guidelines. The scientific search, carried out until July 2020, considered guidelines in English language of the last thirteen years. Results: Six guidelines were analyzed, from which emerges that a multidisciplinary approach, comprehensive of pharmacologic and nonpharmacologic interventions, should drive neuropathic pain management. A relevant role in non-pharmacological intervention is played by rehabilitation, through an adequate tailored rehabilitation program and physical therapies. Conclusion: This analysis highlights the importance of rehabilitation but also the lack of evidence on various rehabilitative practices. Arises hence the need for further studies in this field to better define a rehabilitative treatment strategy. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)
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20 pages, 461 KiB  
Review
A Systematic Review of Pharmacologic and Rehabilitative Treatment of Small Fiber Neuropathies
by Michele Vecchio, Rita Chiaramonte, Marcello Romano, Piero Pavone, Giuseppe Musumeci and Giulia Letizia Mauro
Diagnostics 2020, 10(12), 1022; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10121022 - 28 Nov 2020
Cited by 9 | Viewed by 4300
Abstract
The aim of this systematic review is to guide the physician in defining the pharmacologic and rehabilitative therapeutic approaches for adopting the best strategies described in the current literature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Science to [...] Read more.
The aim of this systematic review is to guide the physician in defining the pharmacologic and rehabilitative therapeutic approaches for adopting the best strategies described in the current literature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Science to identify the treatment of small fiber neuropathies. Two reviewers independently reviewed and came to a consensus on which articles met inclusion/exclusion criteria. The authors excluded the duplicates, animal studies and included the English articles in which the treatment of patients with small fiber neuropathies was described. The search identified a total of 975 articles with the keywords “small fiber neuropathy” AND “rehabilitation” OR “therapy” OR “treatment”. Seventy-eight selected full-text were analyzed by the reviewers. Forty-two publications met the inclusion criteria and were included in the systematic review to describe the rehabilitative and pharmacologic treatment of small fiber neuropathies. Despite the range of different protocols of treatment for small fiber neuropathy, other robust trials are needed. In addition, always different therapeutic approaches are used; a unique protocol could be important for the clinicians. More research is needed to build evidence for the best strategy and to delineate a definitive therapeutic protocol. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)
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18 pages, 565 KiB  
Review
A Systematic Review of the Diagnostic Methods of Small Fiber Neuropathies in Rehabilitation
by Rita Chiaramonte, Marcello Romano and Michele Vecchio
Diagnostics 2020, 10(9), 613; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10090613 - 20 Aug 2020
Cited by 11 | Viewed by 3768
Abstract
This systematic review describes the several methods to diagnose and measure the severity of small fiber neuropathies and aims to guide the physician to define all the diagnostic approaches for adopting the best strategies described in the current literature. The search was conducted [...] Read more.
This systematic review describes the several methods to diagnose and measure the severity of small fiber neuropathies and aims to guide the physician to define all the diagnostic approaches for adopting the best strategies described in the current literature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Science. Two reviewers independently reviewed and came to consensus on which articles met inclusion/exclusion criteria. The authors excluded all the duplicates, animals’ studies, and included the English articles in which the diagnostic measures were finalized to assess the effectiveness of rehabilitation and pharmacologic treatment of patients with small fiber neuropathies. The search identified a total of 975 articles with the keywords “small fiber neuropathy” AND “rehabilitation” OR “therapy” OR “treatment”. Seventy-eight selected full-text were analyzed by the reviewers. Forty-one publications met the inclusion criteria and were included in the systematic review. Despite the range of diagnostic tools for the assessment of small fiber neuropathy, other robust trials are needed. In addition, always different diagnostic approaches are used, a unique protocol could be important for the clinicians. More research is needed to build evidence for the best diagnostic methodologies and to delineate a definitive diagnostic protocol. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)
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Other

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9 pages, 219 KiB  
Brief Report
Small Fibre Involvement in Multifocal Motor Neuropathy Explored with Sudoscan: A Single-Centre Experience
by Marco Luigetti, Silvia Giovannini, Angela Romano, Giulia Bisogni, Francesco Barbato, Andrea Di Paolantonio, Serenella Servidei, Giuseppe Granata and Mario Sabatelli
Diagnostics 2020, 10(10), 755; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10100755 - 26 Sep 2020
Cited by 2 | Viewed by 2203
Abstract
Objective: Multifocal motor neuropathy (MMN) is a rare inflammatory neuropathy, clinically characterized by exclusive motor involvement. We wished to evaluate the possible presence of sensory dysfunction, including the evaluation of small fibres, after a long-term disease course. Patients and methods: seven MMN patients, [...] Read more.
Objective: Multifocal motor neuropathy (MMN) is a rare inflammatory neuropathy, clinically characterized by exclusive motor involvement. We wished to evaluate the possible presence of sensory dysfunction, including the evaluation of small fibres, after a long-term disease course. Patients and methods: seven MMN patients, regularly followed in our Neurology Department, underwent clinical evaluation, neurophysiological examination by nerve conduction studies (NCSs), and Sudoscan. We compared neurophysiological data with a group of patients with other disorders of the peripheral nervous system. Results: NCSs showed a reduction of sensory nerve action potential amplitude in 2/7 MMN patients. Sudoscan showed borderline electrochemical skin conductance (ESC) values in 3/7 MMN patients (two of them with abnormal sensory NCSs). Conclusions: Our results confirm that sensory involvement may be found in some MMN after a long-term disease course, and it could also involve the small fibres. Full article
(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management)
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