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@article{Baron:2016:10.1097/j.pain.0000000000000753,
author = {Baron, R and Maier, C and Attal, N and Binder, A and Bouhassira, D and Cruccu, G and Finnerup, NB and Haanpaa, M and Hansson, P and Huellemann, P and Jensen, TS and Freynhagen, R and Kennedy, JD and Magerl, W and Mainka, T and Reimer, M and Rice, ASC and Segerdahl, M and Serra, J and Sindrup, S and Sommer, C and Toelle, T and Vollert, J and Treede, R-D},
doi = {10.1097/j.pain.0000000000000753},
journal = {PAIN},
pages = {261--272},
title = {Peripheral neuropathic pain: a mechanism-related organizing principle based on sensory profiles},
url = {http://dx.doi.org/10.1097/j.pain.0000000000000753},
volume = {158},
year = {2016}
}

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TY  - JOUR
AB  - Patients with neuropathic pain are heterogeneous in etiology, pathophysiology, and clinical appearance. They exhibit a variety of pain-related sensory symptoms and signs (sensory profile). Different sensory profiles might indicate different classes of neurobiological mechanisms, and hence subgroups with different sensory profiles might respond differently to treatment. The aim of the investigation was to identify subgroups in a large sample of patients with neuropathic pain using hypothesis-free statistical methods on the database of 3 large multinational research networks (German Research Network on Neuropathic Pain (DFNS), IMI-Europain, and Neuropain). Standardized quantitative sensory testing was used in 902 (test cohort) and 233 (validation cohort) patients with peripheral neuropathic pain of different etiologies. For subgrouping, we performed a cluster analysis using 13 quantitative sensory testing parameters. Three distinct subgroups with characteristic sensory profiles were identified and replicated. Cluster 1 (sensory loss, 42%) showed a loss of small and large fiber function in combination with paradoxical heat sensations. Cluster 2 (thermal hyperalgesia, 33%) was characterized by preserved sensory functions in combination with heat and cold hyperalgesia and mild dynamic mechanical allodynia. Cluster 3 (mechanical hyperalgesia, 24%) was characterized by a loss of small fiber function in combination with pinprick hyperalgesia and dynamic mechanical allodynia. All clusters occurred across etiologies but frequencies differed. We present a new approach of subgrouping patients with peripheral neuropathic pain of different etiologies according to intrinsic sensory profiles. These 3 profiles may be related to pathophysiological mechanisms and may be useful in clinical trial design to enrich the study population for treatment responders.
AU  - Baron,R
AU  - Maier,C
AU  - Attal,N
AU  - Binder,A
AU  - Bouhassira,D
AU  - Cruccu,G
AU  - Finnerup,NB
AU  - Haanpaa,M
AU  - Hansson,P
AU  - Huellemann,P
AU  - Jensen,TS
AU  - Freynhagen,R
AU  - Kennedy,JD
AU  - Magerl,W
AU  - Mainka,T
AU  - Reimer,M
AU  - Rice,ASC
AU  - Segerdahl,M
AU  - Serra,J
AU  - Sindrup,S
AU  - Sommer,C
AU  - Toelle,T
AU  - Vollert,J
AU  - Treede,R-D
DO  - 10.1097/j.pain.0000000000000753
EP  - 272
PY  - 2016///
SN  - 0304-3959
SP  - 261
TI  - Peripheral neuropathic pain: a mechanism-related organizing principle based on sensory profiles
T2  - PAIN
UR  - http://dx.doi.org/10.1097/j.pain.0000000000000753
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000397015500010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/49558
VL  - 158
ER  -

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