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Neuropathic pain: an updated grading system for research and clinical practice
The redefinition of neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system,” which was suggested by the International Association for the Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely ac...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949003/ https://www.ncbi.nlm.nih.gov/pubmed/27115670 http://dx.doi.org/10.1097/j.pain.0000000000000492 |
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author | Finnerup, Nanna B. Haroutounian, Simon Kamerman, Peter Baron, Ralf Bennett, David L.H. Bouhassira, Didier Cruccu, Giorgio Freeman, Roy Hansson, Per Nurmikko, Turo Raja, Srinivasa N. Rice, Andrew S.C. Serra, Jordi Smith, Blair H. Treede, Rolf-Detlef Jensen, Troels S. |
author_facet | Finnerup, Nanna B. Haroutounian, Simon Kamerman, Peter Baron, Ralf Bennett, David L.H. Bouhassira, Didier Cruccu, Giorgio Freeman, Roy Hansson, Per Nurmikko, Turo Raja, Srinivasa N. Rice, Andrew S.C. Serra, Jordi Smith, Blair H. Treede, Rolf-Detlef Jensen, Troels S. |
author_sort | Finnerup, Nanna B. |
collection | PubMed |
description | The redefinition of neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system,” which was suggested by the International Association for the Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system. As of February, 2015, 608 eligible articles in Scopus cited the paper, 414 of which cited the neuropathic pain definition. Of 220 clinical studies citing the paper, 56 had used the grading system. The percentage using the grading system increased from 5% in 2009 to 30% in 2014. Obstacles to a wider use of the grading system were identified, including (1) questions about the relative significance of confirmatory tests, (2) the role of screening tools, and (3) uncertainties about what is considered a neuroanatomically plausible pain distribution. Here, we present a revised grading system with an adjusted order, better reflecting clinical practice, improvements in the specifications, and a word of caution that even the “definite” level of neuropathic pain does not always indicate causality. In addition, we add a table illustrating the area of pain and sensory abnormalities in common neuropathic pain conditions and propose areas for further research. |
format | Online Article Text |
id | pubmed-4949003 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-49490032016-08-03 Neuropathic pain: an updated grading system for research and clinical practice Finnerup, Nanna B. Haroutounian, Simon Kamerman, Peter Baron, Ralf Bennett, David L.H. Bouhassira, Didier Cruccu, Giorgio Freeman, Roy Hansson, Per Nurmikko, Turo Raja, Srinivasa N. Rice, Andrew S.C. Serra, Jordi Smith, Blair H. Treede, Rolf-Detlef Jensen, Troels S. Pain Comprehensive Review The redefinition of neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system,” which was suggested by the International Association for the Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system. As of February, 2015, 608 eligible articles in Scopus cited the paper, 414 of which cited the neuropathic pain definition. Of 220 clinical studies citing the paper, 56 had used the grading system. The percentage using the grading system increased from 5% in 2009 to 30% in 2014. Obstacles to a wider use of the grading system were identified, including (1) questions about the relative significance of confirmatory tests, (2) the role of screening tools, and (3) uncertainties about what is considered a neuroanatomically plausible pain distribution. Here, we present a revised grading system with an adjusted order, better reflecting clinical practice, improvements in the specifications, and a word of caution that even the “definite” level of neuropathic pain does not always indicate causality. In addition, we add a table illustrating the area of pain and sensory abnormalities in common neuropathic pain conditions and propose areas for further research. Wolters Kluwer 2016-01-13 2016-08 /pmc/articles/PMC4949003/ /pubmed/27115670 http://dx.doi.org/10.1097/j.pain.0000000000000492 Text en © 2016 International Association for the Study of Pain This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY (http://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Comprehensive Review Finnerup, Nanna B. Haroutounian, Simon Kamerman, Peter Baron, Ralf Bennett, David L.H. Bouhassira, Didier Cruccu, Giorgio Freeman, Roy Hansson, Per Nurmikko, Turo Raja, Srinivasa N. Rice, Andrew S.C. Serra, Jordi Smith, Blair H. Treede, Rolf-Detlef Jensen, Troels S. Neuropathic pain: an updated grading system for research and clinical practice |
title | Neuropathic pain: an updated grading system for research and clinical practice |
title_full | Neuropathic pain: an updated grading system for research and clinical practice |
title_fullStr | Neuropathic pain: an updated grading system for research and clinical practice |
title_full_unstemmed | Neuropathic pain: an updated grading system for research and clinical practice |
title_short | Neuropathic pain: an updated grading system for research and clinical practice |
title_sort | neuropathic pain: an updated grading system for research and clinical practice |
topic | Comprehensive Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949003/ https://www.ncbi.nlm.nih.gov/pubmed/27115670 http://dx.doi.org/10.1097/j.pain.0000000000000492 |
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