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Neuropathic Pain: Correct Diagnosis for Correct Management 2.0

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

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 19316

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Special Issue Editor

Dr. Daniele Coraci

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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 form of pain is the neuropathic type: a debilitating condition, affecting 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 origin and modifying factors are known to be complex. Furthermore, several situations may cause this condition. For these reasons, extensive knowledge of the mechanisms of neuropathic pain and correct diagnosis is fundamental for 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 second edition of the Special Issue is more focused on neuropathic pain as part of specific diseases.

The main aims are:

The evaluation of the evidence related to the diagnostic tools for 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.

For this edition, the additional fields of interest are:

Traumas and diseases of orthopedic significance;
Neurological diseases;
Oncology;
Psychology;
Anesthesiology;
Radiology and radiation therapy.

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 (3 papers)

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Review

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19 pages, 368 KiB

Open AccessReview

Possible Neuropathic Pain in Clinical Practice—Review on Selected Diagnostic Tools and Its Further Challenges

by Anna K. Szewczyk, Anna Jamroz-Wiśniewska and Konrad Rejdak

Diagnostics 2023, 13(1), 108; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13010108 - 29 Dec 2022

Cited by 3 | Viewed by 1688

Abstract

Background: Neuropathic pain (NeP) is a wide group of conditions provoked by many different causes and with different patterns. The creation of a grading system was intended to determine the level of certainty that the pain is of neuropathic nature. Methods: The aim of this review is to update previously published data on some NeP questionnaires and their measurement properties. The selection of articles is based on the basic neurological units. To assess the usefulness and credibility of the questionnaires, the authors searched for a commonly used measure of reliability, as well as sensitivity and specificity. Results: Studies regarding the usefulness and credibility of questionnaires used in NeP were realized. Different patient cohorts, etiologies and sample sizes, do not allow for an unambiguous comparison of the presented scales; however, all of these studies found good measures of reliability, specificity and sensitivity. Conclusions: NeP tools seem to be beneficial screening instruments that should be utilized by specialists and general practitioners to improve the recognition of “possible” NeP and to determine the epidemiology of this disorder. They have been developed to distinguish perceived pain into neuropathic and non-neuropathic, and, therefore, patients with a mixed pain can still present a diagnostic challenge. Clinical examination and interview play an essential role in the diagnostic process and monitoring, and cannot be neglected. Full article

(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management 2.0)

13 pages, 1022 KiB

Open AccessReview

The Management of Poststroke Thalamic Pain: Update in Clinical Practice

by Songjin Ri

Diagnostics 2022, 12(6), 1439; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12061439 - 10 Jun 2022

Cited by 7 | Viewed by 13274

Abstract

Poststroke thalamic pain (PS-TP), a type of central poststroke pain, has been challenged to improve the rehabilitation outcomes and quality of life after a stroke. It has been shown in 2.7–25% of stroke survivors; however, the treatment of PS-TP remains difficult, and in majority of them it often failed to manage the pain and hypersensitivity effectively, despite the different pharmacotherapies as well as invasive interventions. Central imbalance, central disinhibition, central sensitization, other thalamic adaptative changes, and local inflammatory responses have been considered as its possible pathogenesis. Allodynia and hyperalgesia, as well as the chronic sensitization of pain, are mainly targeted in the management of PS-TP. Commonly recommended first- and second-lines of pharmacological therapies, including traditional medications, e.g., antidepressants, anticonvulsants, opioid analgesics, and lamotrigine, were more effective than others. Nonpharmacological interventions, such as transcranial magnetic or direct current brain stimulations, vestibular caloric stimulation, epidural motor cortex stimulation, and deep brain stimulation, were effective in some cases/small-sized studies and can be recommended in the management of therapy-resistant PS-TP. Interestingly, the stimulation to other areas, e.g., the motor cortex, periventricular/periaqueductal gray matter, and thalamus/internal capsule, showed more effect than the stimulation to the thalamus alone. Further studies on brain or spinal stimulation are required for evidence. Full article

(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management 2.0)

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29 pages, 739 KiB

Open AccessSystematic Review

The Role of Physical Exercise and Rehabilitative Implications in the Process of Nerve Repair in Peripheral Neuropathies: A Systematic Review

by Rita Chiaramonte, Vito Pavone, Gianluca Testa, Isabella Pesce, Dalila Scaturro, Giuseppe Musumeci, Giulia Letizia Mauro and Michele Vecchio

Diagnostics 2023, 13(3), 364; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13030364 - 18 Jan 2023

Cited by 6 | Viewed by 3336

Abstract

Background: The various mechanisms involved in peripheral nerve regeneration, induced by exercise and electrical nerve stimulation, are still unclear. Objective: The aim of this review was to summarize the influence of physical exercise and/or electrical stimulation on peripheral nerve repair and regeneration and the variation of impact of intervention depending on timing, as well as kind and dosage of the intervention. A literature survey was conducted on PubMed, Scopus, and Web of Science, between February 2021 to July 2021, with an update in September 2022. Methodology: The literature search identified 101,386 articles with the keywords: “peripheral nerve” OR “neuropathy” AND “sprouting” OR “neuroapraxia” OR “axonotmesis” OR “neurotmesis” OR “muscle denervation” OR “denervated muscle” AND “rehabilitation” OR “physical activity” OR “physical exercise” OR “activity” OR “electrical stimulation”. A total of 60 publications were included. Eligible studies were focused on evaluating the process of nerve repair (biopsy, electromyographic parameters or biomarker outcomes) after electrical stimulation or physical exercise interventions on humans or animals with peripheral sensory or motor nerve injury. Synthesis: This study shows that the literature, especially regarding preclinical research, is mainly in agreement that an early physical program with active exercise and/or electrical stimulation promotes axonal regenerative responses and prevents maladaptive response. This was evaluated by means of changes in electrophysiological recordings of CMAPs for latency amplitude, and the sciatic functional index (SFI). Furthermore, this type of activity can cause an increase in weight and in muscle fiber diameter. Nevertheless, some detrimental effects of exercising and electrical stimulation too early after nerve repair were recorded. Conclusion: In most preclinical studies, peripheral neuropathy function was associated with improvements after physical exercise and electrical stimulation. For humans, too little research has been conducted on this topic to reach a complete conclusion. This research supports the need for future studies to test the validity of a possible rehabilitation treatment in humans in cases of peripheral neuropathy to help nerve sprouting. Full article

(This article belongs to the Special Issue Neuropathic Pain: Correct Diagnosis for Correct Management 2.0)

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