Mechanical Allodynia Predicts Better Outcome of Surgical Decompression for Painful Diabetic Peripheral Neuropathy

2018 ◽  
Vol 34 (06) ◽  
pp. 446-454 ◽  
Author(s):  
Chenlong Liao ◽  
D. Nickerson ◽  
Massimiliano Visocchi ◽  
Min Yang ◽  
Pengfei Liu ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Surgical Outcome ◽  
Diabetic Peripheral Neuropathy ◽  
Mechanical Allodynia ◽  
Depression Scale ◽  
Pain Reduction ◽  
Control Group ◽  
Cross Sectional ◽  
Painful Diabetic Peripheral Neuropathy ◽  
High Resolution Ultrasonography

Background To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN). Materials and Methods Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups were further divided into subgroups based on the presence of MA on admission. Clinical evaluations including the visual analog scale (VAS), the Hospital Anxiety and Depression Scale (HADS), nerve conduction velocity (NCV), and high-resolution ultrasonography (cross-sectional area, CSA) were performed preoperatively and postoperatively. Results The levels of VAS and HADS and the results of NCV and CSA were improved in the surgical group (p < 0.05). In the surgical subgroups, pain reduction, psychiatric amelioration, improvement in NCVs, and the restoration of the CSA were observed in patients with signs of MA (p < 0.05), whereas only pain reduction, psychiatric amelioration, and restoration of the CSA were noted in patients without signs of MA (p > 0.05). Furthermore, better pain reduction was achieved in patients with MA when compared with those without MA (p < 0.05). Conclusions MA is proved to be a reliable predictor of good surgical outcome for painful DPN.

scholarly journals Spexin Levels are Associated with Painful Diabetic Peripheral Neuropathy

2021 ◽  
Author(s):  
Lu Zhu ◽  
Hangping Zheng ◽  
Yaojing Jiang ◽  
Qi Zhang ◽  
Bin Lu ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Antinociceptive Effect ◽  
Experimental Studies ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional

Abstract Background: Spexin is implicated in multiple functions of energy metabolism and glucose homeostasis regulation. Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes and approximately half of the patients with DPN suffer from neuropathic pain. Recent experimental studies in mice have shown that Spexin has an antinociceptive effect, but there are no relevant reports in clinical studies. This study aimed to evaluate Spexin levels in people with painful DPN and controls and assess the correlation between serum Spexin levels and painful DPN.Methods: This is a cross-sectional study including 20 patients with diabetes but without DPN (non-DPN) as a control group, 24 patients with painless DPN, and 16 patients with painful DPN. Questionnaires and laboratory surveys were conducted to collect demographic and clinical data. The existence and severity of DPN were assessed using neurological symptom score, neurological examination, and electromyography. Serum Spexin levels were measured by ELISA. Results: Serum Spexin levels of patients with painful DPN were significantly lower than those of non-DPN patients (p<0.001) and painless DPN patients (p=0.035). Serum Spexin levels were negatively correlated with neuropathic pain score. Compared with individuals with higher levels of Spexin, the prevalence rate of painful DPN in those with lower levels of Spexin was significantly higher. Binary logistic regression analysis showed that the odds ratios for painful DPN were significantly elevated along with decreasing Spexin levels even after adjusting for age, sex, BMI, diabetes duration, HbA1c, 2hPBG, hypertension and smoking or drinking status. serum Spexin levels have a sensitivity of 84.1% and a specificity of 56.2% for predicting painful DPN.Conclusions: Decreased serum Spexin levels were strongly associated with painful DPN, suggesting a possible role of this peptide in pain-related pathogenesis.

scholarly journals Spexin is associated with Painful Diabetic Peripheral Neuropathy

2021 ◽  
Author(s):  
Lu Zhu ◽  
Ping hang Zheng ◽  
jing yao Jiang ◽  
Qi Zhang ◽  
Bin Lu ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Antinociceptive Effect ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Lower Serum Level ◽  
Patients With Diabetes

Abstract Background: Spexin exerts multiple functions in the regulation of energy metabolism and glucose homeostasis. Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes and almost one-third of patients with DPN suffer from neuropathic pain. Recent studies have shown that Spexin has antinociceptive effect. This study aims to evaluate the correlation between circulating Spexin level with the painful DPN. Methods: This is a cross-sectional study including 20 patients with diabetes but without DPN (non-DPN) as the control group, 24 patients with painless DPN and 16 patients with painful DPN. A questionnaire and laboratory investigation were carried out to obtain information on demographic and clinical data. The existence and severity of DPN was assessed by electromyography (EMG) examination. Serum Spexin level was measured by ELISA. Results: The serum Spexin level of patients with painful DPN was significantly lower than that of non-DPN patients (p<0.001) and painless DPN patients (p=0.035). The binary logistic regression analysis showed that lower serum level of Spexin was independently associated with the presence of painful DPN after adjusting for age, sex, BMI, duration of diabetes, HbA1c, 2hPBG, hypertension and status of smoking or drinking. Compared to individuals with higher level of Spexin, the prevalence rate of painful DPN in those with lower level of Spexin was significantly higher. Conclusion: Circulating Spexin level decreased in painful DPN, suggesting a possible role of this peptide in pain-related pathogenesis.

scholarly journals Painful Diabetic Peripheral Neuropathy Study of Chinese OutPatiEnts (PDN-SCOPE): protocol for a multicentre cross-sectional registry study of clinical characteristics and treatment in China

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025722
Author(s):  
Yuanjin Zhang ◽  
Nan Li ◽  
Yiming Zhao ◽  
Dongsheng Fan
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Clinical Characteristics ◽  
Medical Science ◽  
Visual Analogue Scale Pain ◽  
Anxiety And Depression ◽  
Registry Study ◽  
Cross Sectional ◽  
Treatment Practices ◽  
Painful Diabetic Peripheral Neuropathy

IntroductionPainful diabetic peripheral neuropathy (PDN) is a growing public health problem in China. Despite recent progress in treatment, there has been no nationwide study evaluating current medical practices and compliance with treatment guidelines. The primary aims of this study are to investigate the clinical characteristics and treatment practices for PDN and associated anxiety and depression in China.Methods and analysisPainful Diabetic Peripheral Neuropathy Study of Chinese OutPatiEnts is a cross-sectional, multicentre registry study with a target sample size of approximately 1500 people experiencing PDN. People with PDN will be treated according to current guidelines and local practices. The demographics, medical histories, Visual Analogue Scale pain scores, Patient Health Questionnaire-9 results, Generalised Anxiety Disorder-7 scores and therapies will be recorded to evaluate clinical characteristics of PDN and current treatment practices for pain, anxiety and depression.Ethics and disseminationEthical approval has been obtained from the Peking University Third Hospital Medical Science Research Ethics Committee (2018–182).The results of this study will be disseminated through peer-reviewed publications and scientific presentations.Trial registration numberNCT03520608

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