Abstract
Background: Neuropathic pain is an increasingly prevalent condition and has a major impact on health and quality of life. However, the risk factors for the development and maintenance of neuropathic pain are poorly understood. Clinical, genetic and psychosocial factors all contribute to chronic pain, but their interactions have not been studied in large cohorts. The DOLORisk study aims to study these factors. Protocol: Multicentre cross-sectional and longitudinal cohorts covering the main causes leading to neuropathic pain (e.g. diabetes, surgery, chemotherapy, traumatic injury), as well as rare conditions, follow a common protocol for phenotyping of the participants. This core protocol correlates answers given by the participants on a set of questionnaires with the results of their genetic analyses. A smaller number of participants undergo deeper phenotyping procedures, including neurological examination, nerve conduction studies, threshold tracking, quantitative sensory testing, conditioned pain modulation and electroencephalography. Ethics and dissemination: All studies have been approved by their regional ethics committees as required by national law. Results are disseminated through the DOLORisk website, scientific meetings, open-access publications, and in partnership with patient organisations. Strengths and limitations: Large cohorts covering many possible triggers for neuropathic painMulti-disciplinary approach to study the interaction of clinical, psychosocial and genetic risk factorsHigh comparability of the data across centres thanks to harmonised protocolsOne limitation is that the length of the questionnaires might reduce the response rate and quality of responses of participants.
Highlights
Neuropathic pain affects 7–10% of the general population[1] and has a major impact on physical health, psychological health and quality of life[2]
The prevalence of neuropathic pain will increase due to the increasing prevalence of predisposing conditions, such as diabetes mellitus, and ageing, which is associated with neuropathic pain[1]
Based on the analysis of these risk factors, the study will lead to the development of a risk model for neuropathic pain, combining measurable genetic and environmental factors
Summary
Neuropathic pain affects 7–10% of the general population[1] and has a major impact on physical health, psychological health and quality of life[2]. Not all patients with such a lesion develop neuropathic pain. We do not understand why only a sub-group of patients with the same disease or neurological lesion develop neuropathic pain. A plausible explanation for the variation in neuropathic pain prevalence and severity is a complex interaction between genetic, psychosocial, and clinical risk factors in a vulnerable individual[6,7,8]. Aims and objectives DOLORisk is a multi-centre observational study that aims to understand the risk factors and determinants for neuropathic pain. Secondary objectives DOLORisk aims to determine if patient stratification using physiological and psychological factors can predict neuropathic pain risk and progression. Based on the analysis of these risk factors, the study will lead to the development of a risk model for neuropathic pain, combining measurable genetic and environmental factors
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