• Pain · Jul 2024

    What is associated with painful polyneuropathy? A cross-sectional analysis of symptoms and signs in patients with painful and painless polyneuropathy.

    • Janne Gierthmühlen, Nadine Attal, Georgios Baskozos, Kristine Bennedsgaard, David L Bennett, Didier Bouhassira, Geert Crombez, Nanna B Finnerup, Yelena Granovsky, Troels Staehelin Jensen, Jishi John, Lieven Nils Kennes, Helen Laycock, Mathilde M V Pascal, RiceAndrew S CASCPain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, United Kingdom., Leah Shafran-Topaz, Andreas C Themistocleous, David Yarnitsky, and Ralf Baron.
    • Interdisciplinary Pain Unit, Department of Anesthesiology and Surgical Intensive Care Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.
    • Pain. 2024 Jul 3.

    AbstractIt is still unclear how and why some patients develop painful and others painless polyneuropathy. The aim of this study was to identify multiple factors associated with painful polyneuropathies (NeuP). A total of 1181 patients of the multicenter DOLORISK database with painful (probable or definite NeuP) or painless (unlikely NeuP) probable or confirmed neuropathy were investigated clinically, with questionnaires and quantitative sensory testing. Multivariate logistic regression including all variables (demographics, medical history, psychological symptoms, personality items, pain-related worrying, life-style factors, as well as results from clinical examination and quantitative sensory testing) and machine learning was used for the identification of predictors and final risk prediction of painful neuropathy. Multivariate logistic regression demonstrated that severity and idiopathic etiology of neuropathy, presence of chronic pain in family, Patient-Reported Outcomes Measurement Information System Fatigue and Depression T-Score, as well as Pain Catastrophizing Scale total score are the most important features associated with the presence of pain in neuropathy. Machine learning (random forest) identified the same variables. Multivariate logistic regression archived an accuracy above 78%, random forest of 76%; thus, almost 4 out of 5 subjects can be classified correctly. This multicenter analysis shows that pain-related worrying, emotional well-being, and clinical phenotype are factors associated with painful (vs painless) neuropathy. Results may help in the future to identify patients at risk of developing painful neuropathy and identify consequences of pain in longitudinal studies.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.

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