Quantitative Sensory Testing as a Predictor of Neuropathic Pain in Diabetic Patients
Diabetic neuropathy is one of the most common complications of diabetes, affecting about half of patients with the disease. The development of chronic pain is one of the symptoms of diabetic neuropathy, occurring mainly in the extremities of the limbs, manifested as exacerbated responses to sensorial stimuli, with different sensory profiles associated with pain and the responsiveness to analgesia. The objective of this study was to evaluate the informative value of the Quantitative Sensory Testing (QST) items with regard to predicting the Douleur Neuropathique en 4 (DN4) and McGill Pain Questionnaire (MPQ) pain classification. A machine-learning approach was used to analyze data collected from 29 men and 26 women, all diagnosed with Diabetes mellitus. Results showed that QST items on their own have low predictive value in regard to both DN4 and MPQ. However, when combined with sociodemographic, affective and cognitive factors, predictive value increased for MPQ, depending on classifier and number of selected items. In general, hand-related QST items had higher informative value than feet-related items. These results indicate that QST are potentially useful as a complementary tool for identifying chronic pain in diabetic patients.