The characteristics of pain and dysesthesia in patients with diabetic polyneuropathy

Sandra Sif Gylfadottir; Mustapha Itani; Alexander Gramm Kristensen; Pall Karlsson; Thomas Krøigård; David L Bennett; Hatice Tankisi; Niels Trolle Andersen; Troels Staehelin Jensen; Søren Hein Sindrup; Nanna Brix Finnerup

doi:10.1371/journal.pone.0263831

The characteristics of pain and dysesthesia in patients with diabetic polyneuropathy

Sandra Sif Gylfadottir, Mustapha Itani, Alexander Gramm Kristensen, Pall Karlsson, Thomas Krøigård, David L Bennett, Hatice Tankisi, Niels Trolle Andersen, Troels Staehelin Jensen, Søren Hein Sindrup, Nanna Brix Finnerup

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

14 Citations (Scopus)

Abstract

INTRODUCTION/AIMS: Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile, neuropathy severity, and impact of painful DPN and dysesthetic DPN.

METHODS: This study was a cross-sectional study of type 2 diabetes patients with confirmed DPN, diagnosed using widely accepted methods including a clinical examination, skin biopsy, and nerve conduction studies.

FINDINGS: Of 126 patients with confirmed DPN, 52 had DPN without pain or dysesthesia, 21 had dysesthetic DPN, and 53 painful DPN. Patients with painful DPN were less physically active and suffered from more pain elsewhere than in the feet compared to patients with DPN without pain. Patients with painful DPN had the largest loss of small and large sensory fiber function, and there was a gradient of larger spatial distribution of sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. This could indicate that patients with dysesthesia had more severe neuropathy than patients without dysesthesia but less than patients with painful DPN. Patients with dysesthetic and painful DPN had higher symptom scores for depression and fatigue than those without dysesthesia/pain with no difference between dysesthetic and painful DPN.

CONCLUSIONS: There was a gradient of increasing sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. Pain and dysesthesia are common in DPN and both interfere with daily life. It is therefore important to consider dysesthesia when diagnosing and treating patients with neuropathy.

Original language	English
Article number	e0263831
Journal	PLOS ONE
Volume	17
Issue	2
Number of pages	15
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0263831
Publication status	Published - Feb 2022

Keywords

BURDEN
DEPRESSION
DIAGNOSTIC-CRITERIA
ILLNESS
MECHANISMS
NEUROPATHIC PAIN
PHENOTYPE
PREDICTOR
PROTOCOL
SPINAL-CORD-INJURY

Access to Document

10.1371/journal.pone.0263831Licence: CC BY

Cite this

@article{1fbfe82cc50743b7a09fe885c731f0ea,

title = "The characteristics of pain and dysesthesia in patients with diabetic polyneuropathy",

abstract = "INTRODUCTION/AIMS: Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile, neuropathy severity, and impact of painful DPN and dysesthetic DPN.METHODS: This study was a cross-sectional study of type 2 diabetes patients with confirmed DPN, diagnosed using widely accepted methods including a clinical examination, skin biopsy, and nerve conduction studies.FINDINGS: Of 126 patients with confirmed DPN, 52 had DPN without pain or dysesthesia, 21 had dysesthetic DPN, and 53 painful DPN. Patients with painful DPN were less physically active and suffered from more pain elsewhere than in the feet compared to patients with DPN without pain. Patients with painful DPN had the largest loss of small and large sensory fiber function, and there was a gradient of larger spatial distribution of sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. This could indicate that patients with dysesthesia had more severe neuropathy than patients without dysesthesia but less than patients with painful DPN. Patients with dysesthetic and painful DPN had higher symptom scores for depression and fatigue than those without dysesthesia/pain with no difference between dysesthetic and painful DPN.CONCLUSIONS: There was a gradient of increasing sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. Pain and dysesthesia are common in DPN and both interfere with daily life. It is therefore important to consider dysesthesia when diagnosing and treating patients with neuropathy.",

keywords = "BURDEN, DEPRESSION, DIAGNOSTIC-CRITERIA, ILLNESS, MECHANISMS, NEUROPATHIC PAIN, PHENOTYPE, PREDICTOR, PROTOCOL, SPINAL-CORD-INJURY",

author = "Gylfadottir, {Sandra Sif} and Mustapha Itani and Kristensen, {Alexander Gramm} and Pall Karlsson and Thomas Kr{\o}ig{\aa}rd and Bennett, {David L} and Hatice Tankisi and Andersen, {Niels Trolle} and Jensen, {Troels Staehelin} and Sindrup, {S{\o}ren Hein} and Finnerup, {Nanna Brix}",

year = "2022",

month = feb,

doi = "10.1371/journal.pone.0263831",

language = "English",

volume = "17",

journal = "PLOS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "2",

}

TY - JOUR

T1 - The characteristics of pain and dysesthesia in patients with diabetic polyneuropathy

AU - Gylfadottir, Sandra Sif

AU - Itani, Mustapha

AU - Kristensen, Alexander Gramm

AU - Karlsson, Pall

AU - Krøigård, Thomas

AU - Bennett, David L

AU - Tankisi, Hatice

AU - Andersen, Niels Trolle

AU - Jensen, Troels Staehelin

AU - Sindrup, Søren Hein

AU - Finnerup, Nanna Brix

PY - 2022/2

Y1 - 2022/2

N2 - INTRODUCTION/AIMS: Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile, neuropathy severity, and impact of painful DPN and dysesthetic DPN.METHODS: This study was a cross-sectional study of type 2 diabetes patients with confirmed DPN, diagnosed using widely accepted methods including a clinical examination, skin biopsy, and nerve conduction studies.FINDINGS: Of 126 patients with confirmed DPN, 52 had DPN without pain or dysesthesia, 21 had dysesthetic DPN, and 53 painful DPN. Patients with painful DPN were less physically active and suffered from more pain elsewhere than in the feet compared to patients with DPN without pain. Patients with painful DPN had the largest loss of small and large sensory fiber function, and there was a gradient of larger spatial distribution of sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. This could indicate that patients with dysesthesia had more severe neuropathy than patients without dysesthesia but less than patients with painful DPN. Patients with dysesthetic and painful DPN had higher symptom scores for depression and fatigue than those without dysesthesia/pain with no difference between dysesthetic and painful DPN.CONCLUSIONS: There was a gradient of increasing sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. Pain and dysesthesia are common in DPN and both interfere with daily life. It is therefore important to consider dysesthesia when diagnosing and treating patients with neuropathy.

AB - INTRODUCTION/AIMS: Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile, neuropathy severity, and impact of painful DPN and dysesthetic DPN.METHODS: This study was a cross-sectional study of type 2 diabetes patients with confirmed DPN, diagnosed using widely accepted methods including a clinical examination, skin biopsy, and nerve conduction studies.FINDINGS: Of 126 patients with confirmed DPN, 52 had DPN without pain or dysesthesia, 21 had dysesthetic DPN, and 53 painful DPN. Patients with painful DPN were less physically active and suffered from more pain elsewhere than in the feet compared to patients with DPN without pain. Patients with painful DPN had the largest loss of small and large sensory fiber function, and there was a gradient of larger spatial distribution of sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. This could indicate that patients with dysesthesia had more severe neuropathy than patients without dysesthesia but less than patients with painful DPN. Patients with dysesthetic and painful DPN had higher symptom scores for depression and fatigue than those without dysesthesia/pain with no difference between dysesthetic and painful DPN.CONCLUSIONS: There was a gradient of increasing sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. Pain and dysesthesia are common in DPN and both interfere with daily life. It is therefore important to consider dysesthesia when diagnosing and treating patients with neuropathy.

KW - BURDEN

KW - DEPRESSION

KW - DIAGNOSTIC-CRITERIA

KW - ILLNESS

KW - MECHANISMS

KW - NEUROPATHIC PAIN

KW - PHENOTYPE

KW - PREDICTOR

KW - PROTOCOL

KW - SPINAL-CORD-INJURY

U2 - 10.1371/journal.pone.0263831

DO - 10.1371/journal.pone.0263831

M3 - Journal article

C2 - 35176062

SN - 1932-6203

VL - 17

JO - PLOS ONE

JF - PLOS ONE

IS - 2

M1 - e0263831

ER -

The characteristics of pain and dysesthesia in patients with diabetic polyneuropathy

Abstract

Keywords

Access to Document

Fingerprint

Cite this