For patients with chronic inflammatory demyelinating polyradiculoneuropathy, the presence of neuropathic pain leads to worsened disability and disease outcome, according to a study published in the Journal of the Peripheral Nervous System.
Researchers used the Inflammatory Neuropathy Study of Serbia database to characterize features of neuropathic pain in patients with chronic inflammatory demyelinating polyradiculoneuropathy, and then assessed changes over a 1-year follow-up period. Medical records were used to collect sociodemographic data, diagnostic data, therapeutic modality, comorbidities, functional disability, muscle strength, and levels of depression.
Of the 79 patients included in this study, 16 showed signs of neuropathic pain at baseline and 16 were taking medication for previously diagnosed neuropathic pain. The neuropathic pain cohort experienced a prolonged diagnostic delay (P <.05), a slowly progressive course of disease (P <.05), worse Inflammatory Neuropathy Cause and Treatment sensory score ( P <.01), worse Inflammatory Neuropathy Cause and Treatment disability score (P <.05), as well as a worse Medical Research Council sum score for muscle strength (P <.05), increased depression (P <.01), and a worse disease outcome (P <.05) when compared to the cohort without neuropathic pain. Significant independent predictors of higher painDETECT questionnaire scores included lower Medical Research Council scores (β=−.288, P <.05) and higher Inflammatory Neuropathy Cause and Treatment sensory scores (β=.391, P <.01). Significant differences between the cohorts with and without neuropathic pain were recognized in the areas of mean pain severity, strongest pain severity over the past 4 weeks, average pain severity over the past 4 weeks, pain radiation, and pain characteristics (P <.01, for all). At the 1-year follow-up, pregabalin, gabapentin, or local capsaicin provided significantly reduced neuropathic pain.
Limitations of this study include the small sample size and a large number of outcomes and comparisons.
The researchers concluded “[neuropathic pain] was associated with worse sensory deficit, worse functional disability, worse disease outcome and depression.”
Bjelica B, Peric S, Bozovic I, et al. One-year follow-up study of neuropathic pain in chronic inflammatory demyelinating polyradiculoneuropathy [published online April 11, 2019]. J Peripher Nerv Syst. doi: 10.1111/jns.12318