Challenges of neuropathic pain: focus on diabetic neuropathy

Daniela C. Rosenberger, Vivian Blechschmidt, Hans Timmerman, Andre Wolff, Rolf-Detlef Treede*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)
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Abstract

Neuropathic pain is a frequent condition caused by a lesion or disease of the central or peripheral somatosensory nervous system. A frequent cause of peripheral neuropathic pain is diabetic neuropathy. Its complex pathophysiology is not yet fully elucidated, which contributes to underassessment and undertreatment. A mechanism-based treatment of painful diabetic neuropathy is challenging but phenotype-based stratification might be a way to develop individualized therapeutic concepts. Our goal is to review current knowledge of the pathophysiology of peripheral neuropathic pain, particularly painful diabetic neuropathy. We discuss state-of-the-art clinical assessment, validity of diagnostic and screening tools, and recommendations for the management of diabetic neuropathic pain including approaches towards personalized pain management. We also propose a research agenda for translational research including patient stratification for clinical trials and improved preclinical models in relation to current knowledge of underlying mechanisms.

Original languageEnglish
Pages (from-to)589-624
Number of pages36
JournalJournal of Neural Transmission
Volume127
Issue number4
Early online date8-Feb-2020
DOIs
Publication statusPublished - Apr-2020

Keywords

  • Painful diabetic neuropathy
  • Spinal sensitization
  • Neuroinflammation
  • Quantitative sensory testing
  • Stratification in clinical trials
  • Personalized pain management
  • PERIPHERAL-NERVE INJURY
  • GATED SODIUM-CHANNELS
  • ALPHA-LIPOIC ACID
  • DIAGNOSE DISTAL POLYNEUROPATHY
  • CONTROLLED-RELEASE OXYCODONE
  • RANDOMIZED CONTROLLED-TRIAL
  • GERMAN RESEARCH NETWORK
  • HUMAN SURROGATE MODELS
  • PROTEIN-KINASE-C
  • DOUBLE-BLIND

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