Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F22%3A00076257" target="_blank" >RIV/65269705:_____/22:00076257 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/22:00127722

Výsledek na webu

<a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2034" target="_blank" >https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2034</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/ejp.2034" target="_blank" >10.1002/ejp.2034</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain

Popis výsledku v původním jazyce

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 &apos;loss and gain of function&apos; 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 (&apos;loss of function&apos;), 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 &lt; 0.0042). The proportion of &apos;gain of function&apos; 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 &apos;gain of function&apos; 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 &apos;loss of function&apos; abnormalities in painful polyneuropathy patients. Painful diabetic polyneuropathy probably represents a &apos;more progressed&apos; type of neuropathy with more pronounced somatosensory nerve fibre degeneration. The proportion of &apos;gain of function&apos; sensory abnormalities was low, and these offer limited understanding of pathophysiological mechanisms of spontaneous neuropathic pain.

Název v anglickém jazyce

Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain

Popis výsledku anglicky

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 &apos;loss and gain of function&apos; 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 (&apos;loss of function&apos;), 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 &lt; 0.0042). The proportion of &apos;gain of function&apos; 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 &apos;gain of function&apos; 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 &apos;loss of function&apos; abnormalities in painful polyneuropathy patients. Painful diabetic polyneuropathy probably represents a &apos;more progressed&apos; type of neuropathy with more pronounced somatosensory nerve fibre degeneration. The proportion of &apos;gain of function&apos; sensory abnormalities was low, and these offer limited understanding of pathophysiological mechanisms of spontaneous neuropathic pain.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30210 - Clinical neurology

Projekt

<a href="/cs/project/ED1.1.00%2F02.0068" target="_blank" >ED1.1.00/02.0068: CEITEC - central european institute of technology</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

European journal of pain

ISSN

1090-3801

e-ISSN

1532-2149

Svazek periodika

26

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

15

Strana od-do

2198-2212

Kód UT WoS článku

000854563100001

EID výsledku v databázi Scopus

2-s2.0-85138012435