Neuropathic Pain Studies Guidelines Established

Using phenotype assessments to examine neuropathic pain is not more feasible, according to a report from an expert panel published in Pain.

The group, made up of members from the International Association for the Study of Pain’s Special Interest Group on Neuropathic Pain, gathered to come to a consensus about an agreed, valid, and feasible approach to phenotyping in order to add to the knowledge base of neuropathic pain going forward. The group assessed neuropathic pain studies and realized they met replication difficulties due to the differences in phenotyping capabilities and abilities.

The collaborative team used a three-pronged approach to reach their consensus on phenotyping: first, a systematic literature review of the body of work surrounding neuropathic pain was assessed to identify each of the phenotyping methods used in previous genetic studies. Secondly, the group surveyed the most useful neuropathic phenotypes for their validity and feasibility. Lastly, the group met to discuss and reach a conclusion on the ideal phenotypes that should be collected from neuropathic pain patients for genetic studies.

The study group identified what they called an “entry level” set of phenotypes that should be collected for any genetic study of neuropathic pain. They added that this category includes studies of “possible” neuropathic pain, and controls, and should include the following elements:

• Symptom-based questionnaires to determine whether pain is likely to be neuropathic, which can be described as “hot/ burning” or “evoked by light touch”
• A body chart of checklist to examine whether the pain area is likely to be neuropathic; for example, the pain is consistent with the anatomy of the affected sensory nerves
• Details of family history, including intensity, duration, and any formal diagnosis

The study group added that the entry level “set of phenotypes can be expanded by more extensive and specific measures, as determined by scientific requirements and resource availability,” the paper authors concluded in a press release. “These improvements will facilitate advancements in the field by enabling collaboration between research groups, replication of discoveries of contributing genetic variants, meta-analyses, and translation from the laboratory to the general population, and back again.”

The statement continued that the guidelines were established as part of the 2014-15 Global Year Against Neuropathic Pain campaign, designed to improve awareness among patients and healthcare providers. The International Association for the Study of Pain believes that the campaign will improve recognition and management of neuropathic pain, as they describe it as a disabling and difficult to treat condition.