title: Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4).
abstract: Few studies have directly compared the clinical features of neuropathic and non-neuropathic pains. For this purpose, the French Neuropathic Pain Group developed a clinician-administered questionnaire named DN4 consisting of both sensory descriptors and signs related to bedside sensory examination. This questionnaire was used in a prospective study of 160 patients presenting with pain associated with a definite neurological or somatic lesion. The most common aetiologies of nervous lesions (n=89) were traumatic nerve injury, post herpetic neuralgia and post stroke pain. Non-neurological lesions (n=71) were represented by osteoarthritis, inflammatory arthropathies and mechanical low back pain. Each patient was seen independently by two experts in order to confirm the diagnosis of neuropathic or non-neuropathic pain. The prevalence of pain descriptors and sensory dysfunctions were systematically compared in the two groups of patients. The analysis of the psychometric properties of the DN4 questionnaire included: face validity, inter-rater reliability, factor analysis and logistic regression to identify the discriminant properties of items or combinations of items for the diagnosis of neuropathic pain. We found that a relatively small number of items are sufficient to discriminate neuropathic pain. The 10-item questionnaire developed in the present study constitutes a new diagnostic instrument, which might be helpful both in clinical research and daily practice.
authors.affiliation: INSERM E-332, AP-HP Hôpital Ambroise Paré, Boulogne and Université Versailles-Saint-Quentin, France. didier.bouhassira@apr.ap-hop-paris.fr
authors.forename: Didier
authors.initials: D
authors.lastname: Bouhassira
authors.forename: Nadine
authors.initials: N
authors.lastname: Attal
authors.forename: Haiel
authors.initials: H
authors.lastname: Alchaar
authors.forename: François
authors.initials: F
authors.lastname: Boureau
authors.forename: Bruno
authors.initials: B
authors.lastname: Brochet
authors.forename: Jean
authors.initials: J
authors.lastname: Bruxelle
authors.forename: Gérard
authors.initials: G
authors.lastname: Cunin
authors.forename: Jacques
authors.initials: J
authors.lastname: Fermanian
authors.forename: Patrick
authors.initials: P
authors.lastname: Ginies
authors.forename: Aurélie
authors.initials: A
authors.lastname: Grun-Overdyking
authors.forename: Hélène
authors.initials: H
authors.lastname: Jafari-Schluep
authors.forename: Michel
authors.initials: M
authors.lastname: Lantéri-Minet
authors.forename: Bernard
authors.initials: B
authors.lastname: Laurent
authors.forename: Gérard
authors.initials: G
authors.lastname: Mick
authors.forename: Alain
authors.initials: A
authors.lastname: Serrie
authors.forename: Dominique
authors.initials: D
authors.lastname: Valade
authors.forename: Eric
authors.initials: E
authors.lastname: Vicaut
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013577:Syndrome