Ann Rehabil Med.  2018 Jun;42(3):433-440. 10.5535/arm.2018.42.3.433.

The Availability of Quantitative Assessment of Pain Perception in Patients With Diabetic Polyneuropathy

• Park TJ
• Kim SH
• Lee HC
• Chung SH
• Kim JH
• Park J

• KMID: 2417835
• DOI: http://doi.org/10.5535/arm.2018.42.3.433

Abstract

OBJECTIVE
To evaluate the usefulness of the quantitative assessment of pain perception (QAPP) in diabetic polyneuropathy (DPN) patients.
METHODS
Thirty-two subjects with DPN were enrolled in this study. The subjects' pain perception was assessed quantitatively. Current perception threshold (CPT) and pain equivalent current (PEC) were recorded. All patients were tested with a nerve conduction study (NCS) for evaluation of DPN and pain-related evoked potential (PREP) for evaluation of small fiber neuropathy (SFN) on bilateral upper and lower limbs. All patients were asked to participate in tests such as visual analogue scale (VAS) and SF-36 Health Survey Version 2 to evaluate their subjective pain and quality of life, respectively.
RESULTS
The PEC of QAPP showed significant correlations with VAS (p=0.002) and physical function surveyed with SF-36 Health Survey Version 2 (p=0.035). The results of QAPP had no correlation with NCS, but there was a significant relationship between the CPT of QAPP and PREP (p=0.003).
CONCLUSION
The QAPP may be useful not only in providing objective evaluations of subjective pain in patients with DPN but also in the assessment of diabetic SFN.

Keyword

Diabetic neuropathies; Small fiber neuropathy; Pain measurement; Nociceptive pain

MeSH Terms

Diabetic Neuropathies*
Erythromelalgia
Evoked Potentials
Health Surveys
Humans
Lower Extremity
Neural Conduction
Nociceptive Pain
Pain Measurement
Pain Perception*
Quality of Life

Figure

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  Fig. 1. Measuring position for quantitative assessment of pain perception. While in a comfortable seating position, the electrode patch is attached to the left anterior forearm and the stop switch is held in the right hand.

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  Fig. 2. (A) PEC of QAPP and pain degree showed significant positive correlation (correlation coefficient=0.956, p<0.0001). (B) PEC of QAPP and VAS showed significant positive correlation (correlation coefficient=0.526, p=0.002). (C) PEC of QAPP and physical function in SF-36v2 showed significant negative correlation (correlation coefficient=-0.373, p=0.035). (D) CPT of QAPP and P latency of PREP which was performed in C7 dermatome on the left side showed significant negative correlation (correlation coefficient=-0.511, p=0.003). PEC, pain equivalent current; QAPP, quantitative assessment of pain perception; VAS, visual analogue scale (0–100); CPT, current perception threshold; PREP, pain-related evoked potential.

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