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Consistence and discrepancy of neuropathic pain screening tools DN4 and ID-Pain

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Abstract

Pain is a subjective condition that cannot be objectively measured; for this reason, self patient-perspective is crucial. Recently, several screening tools to discriminate between nociceptive and neuropathic pain have been developed. We aimed at assessing the consistence and discrepancy of two widely used screening tools, The Douleur Neuropathique 4 (DN4) and the 6-item questionnaire (ID-Pain), by comparing their ability in discriminating neuropathic from nociceptive pain. DN4 and ID-Pain were administered to 392 Italian patients attending 16 outpatient services for peripheral nerve diseases. Based on medical history, clinical findings and diagnostic tools, patients were divided into two groups (neuropathic and nociceptive). Globally, ID-Pain identified neuropathic pain in 60 % of patients (38 % probable, 22 % likely). Interestingly also DN4 diagnosed neuropathic pain in 60 % of cases. A discrepancy was observed in 16 % of cases. DN4 and ID-Pain resulted to be highly interrelated in the identification of neuropathic pain. Sensitivity of DN4 was 82 % and specificity was 81 %, while ID-Pain (considering both probable and likely groups) showed sensitivity 78 % and specificity 74 %. Reliable screening tools for neuropathic pain are well related between them; hence, they are available for researchers and clinicians who may choose the most appropriate for their activity. Since the gold standard for the diagnosis and treatment of neuropathic pain cannot do without a neurological evaluation, perhaps DN4, that includes physician objective measures, may help reducing the percentage of dubious cases. Conversely, when needing a more agile tool (not needing a physician) ID-Pain may be adopted.

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Authors and Affiliations

  1. Don Gnocchi Foundation, Milan, Italy

    L. Padua, I. Aprile & C. Pazzaglia

  2. Department of Neurosciences, University of Padua, Padua, Italy

    C. Briani

  3. Department of Neurological Sciences, La Sapienza University, Rome, Italy

    A. Truini, G. Cruccu & F. Galeotti

  4. INSERM U987, CHU Ambroise Pare, APHP, 92100, Boulogne-Billancourt, France

    D. Bouhassirà

  5. Department of Neurology, Neuromuscular Unit, Niguarda Hospital, Milan, Italy

    S. Jann

  6. Department of Neurological Sciences, 2nd Neurology, IRCCS Humanitas Clinical Institute, Milan University, Rozzano, Milan, Italy

    E. Nobile-Orazio

  7. Department of Neurology, Neurophysiology Unit, Ospedale Santa Chiara, Trento, Italy

    A. Morini

  8. EMG Service, ASL 7, Siena, Italy

    M. Mondelli

  9. Clinical Neurophysiology, Neurosurgery Division, CTO Hospital, Turin, Italy

    P. Ciaramitaro

  10. Department of Neurosciences and Biotechnology, Milan University, Monza, Italy

    G. Cavaletti

  11. Clinical Neurophysiology Unit, Neurosciences Department, S. Giovanni Battista Hospital, Turin, Italy

    D. Cocito

  12. Department of Neurology, IRCCS San Raffaele Hospital, Milan, Italy

    R. Fazio

  13. Department on Neurological Sciences, Federico II University, Naples, Italy

    L. Santoro

  14. Department of Neurological Sciences, IRCCS-Fondazione Policlinico, Milan University, Milan, Italy

    M. Carpo

  15. Department of Neurosciences, Bellaria Hospital, Bologna, Italy

    R. Plasmati

  16. Department of Neurology, Hospital S. Andrea, La Spezia, Italy

    L. Benedetti

  17. Department of Neurosciences, Ophthalmology and Genetic, University of Genoa, Genoa, Italy

    A. Schenone

  18. Institute of Neurology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy

    L. Padua

Authors
  1. L. Padua
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  2. C. Briani
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  3. A. Truini
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  4. I. Aprile
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  5. D. Bouhassirà
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  6. G. Cruccu
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  7. S. Jann
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  8. E. Nobile-Orazio
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  9. C. Pazzaglia
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  10. A. Morini
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  11. M. Mondelli
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  13. G. Cavaletti
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  14. D. Cocito
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  15. R. Fazio
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  16. L. Santoro
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  17. F. Galeotti
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  18. M. Carpo
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  19. R. Plasmati
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  20. L. Benedetti
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  21. A. Schenone
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Corresponding author

Correspondence to L. Padua.

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Padua, L., Briani, C., Truini, A. et al. Consistence and discrepancy of neuropathic pain screening tools DN4 and ID-Pain. Neurol Sci 34, 373–377 (2013). https://doi.org/10.1007/s10072-012-1011-3

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  • DOI: https://doi.org/10.1007/s10072-012-1011-3

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