Postherpetic Neuropathy Research Articles

Therapeutic Efficacy of Adipose Tissue-Derived Components in Neuropathic Pain: A Systematic Review.

Neuropathic pain results from a defect in the somatosensory nervous system caused by a diversity of etiologies. The effect of current treat-ment with analgesics and surgery is limited. Studies report the therapeutic use of adipose tissue-derived components to treat neuropathic pain as a new treatment modality. The aim of this systematic review was to investigate the therapeutic clinical efficacy of adipose tissue-derived components on neuro-pathic pain. PubMed, Medline, Cochrane and Embase databases were searched until August 2023. Clinical studies assessing neuropathic pain after autologous fat grafting or the therapeutic use of adipose tissue-derived com-ponents were included. The outcomes of interest were neuropathic pain and quality of life. In total, 433 studies were identified, of which 109 dupli-cates were removed, 324 abstracts were screened and 314 articles were excluded. In total, ten studies were included for comparison. Fat grafting and cellular stromal vascular fraction were used as treatments. Fat grafting indications were post-mastectomy pain syndrome, neuromas, post-herpetic neuropathy, neuro-pathic scar pain and trigeminal neuropathic pain. In seven studies, neuropathic pain levels decreased, and overall, quality of life did not improve. The therapeutic efficacy of adipose tissue-derived components in the treatment of neuropathic pain remains unclear due to the few performed clinical trials with small sample sizes for various indications. Larger and properly designed (randomized) controlled trials are required.

Status of Herpes Zoster and Herpes Zoster Vaccines in 2023: A position paper.

Herpes zoster infection (HZ) is an important public health problem due to its high incidence and frequent complications, especially post-herpetic neuropathy . The incidence of HZ increases with age and is more frequent in immunocompromised patients. It is estimated that at least 60,000 people develop HZ each year in Spain. The usual forms of HZ are so clinically characteristic that they do not usually require microbiological confirmation, which is reserved for cases without cutaneous manifestations or with atypical presentation. There are currently two vaccines approved by the regulatory agencies and marketed in Spain to prevent the onset of HZ and its complications. The first (Zostavax®) was marketed by the company MSD and licensed in Europe in 2006 and is a live attenuated virus vaccine that is administered in a single dose, while the second (Shingrix®) is a recombinant vaccine, marketed in 2017 and requires two doses. While the former cannot be administered to immunocompromised persons, the latter can be prescribed to any group of adults. The criteria for the indication and financing of these vaccines have not been uniform in the various autonomous communities of Spain. These and other aspects of HZ have been discussed by a group of experts from the Illustrious Official College of Physicians of Madrid (ICOMEM) whose criteria and opinions are included in this paper.

Mirogabalin - the use of a new gabapentinoid in the treatment of diabetic neuropathy and postherpetic neuropathy and other conditions

Introduction: Mirogabalin is a new drug from the gabapentinoid group first registered in Japan in 2019. It has found use in the treatment of peripheral neuropathic pain in diabetic neuropathy and postherpetic neuropathy. Purpose: In this article, we review studies on the efficacy and safety of mirogabalin in the treatment of registered indications and its potentially new applications. Materials and Methods: We reviewed the literature available in the PubMed database, using the key words: "mirogabalin", "neuropathy" "pregabalin". Results: Mirogabalin has been registered for the treatment of neuropathic pain in diabetic neuropathy and postherpetic neuropathy. The literature shows that it is effective and safe in the above-mentioned indications. Its use has also been described: in the treatment of neuropathic pain of other etiologies with intolerance to pregabalin, as a coanalgesic in the treatment of pain in the course of cancer, and in neuropathy caused by chemotherapy. It has been shown to be effective in all of the aforementioned cases. Studies have shown no clinically significant effect of mirogabalin in the symptomatic treatment of fibromyalgia pain. It has a good safety profile and a low number of adverse effects. Conclusions:. Mirogabalin is a drug that has the potential to improve the efficacy of treatment of neuropathic pain due to various causes. There is a need to continue conducting studies on larger groups of patients in order to make wider use of its potential in clinical practice.

Contralateral Sensory and Pain Perception Changes in Patients With Unilateral Neuropathy

To test whether contralateral sensory abnormalities in the clinically unaffected area of patients with unilateral neuropathic pain are due to the neuropathy or pain mechanisms. We analyzed the contralateral clinically unaffected side of patients with unilateral painful or painless neuropathy (peripheral nerve injury [PNI], postherpetic neuropathy [PHN], radiculopathy) by standardized quantitative sensory testing following a validated protocol. Primary outcome was the independent contribution of the following variables on the contralateral sensory function using generalized linear regression models: pain intensity, disease duration, etiology, body area, and sensory patterns in the most painful area. Among 424 patients (PNI n = 256, PHN n = 78, radiculopathy n = 90), contralateral sensory abnormalities were frequent in both painful (n = 383) and painless (n = 41) unilateral neuropathy, demonstrating sensory loss for thermal and mechanical nonpainful stimuli and both sensory loss and gain for painful test stimuli. Analysis by etiology revealed contralateral pinprick hyperalgesia in PHN and PNI. Analysis by ipsilateral sensory phenotype demonstrated mirror-image pinprick hyperalgesia in both mechanical and thermal hyperalgesia phenotypes. Pain intensity, etiology, and affected body region predicted changes in only single contralateral somatosensory parameters. Disease duration had no impact on the contralateral sensory function. Mechanisms of sensory loss seem to spread to the contralateral side in both painful and painless neuropathies. Contralateral spread of pinprick hyperalgesia was restricted to the 2 ipsilateral phenotypes that suggest sensitization; this suggest a contribution of descending net facilitation from supraspinal areas, which was reported in rodent models of neuropathic pain but not yet in human patients.

Headache in the Older Population: Causes, Diagnoses, and Treatments.

Primary headaches are less common and differ in presentation in older versus younger individuals. Secondary headaches become more common among older patients. Diagnosis and management of headaches in those > 65years are discussed. Migraine and tension-type headaches are rarely new onset in this age group and should be a diagnosis of exclusion. In older individuals, migraine is more likely to be bilateral with less sensory sensitivities. Migraine aura may present without headache; careful assessment is needed to exclude stroke. Other primary headaches discussed include cough, hypnic, and other headaches. Secondary causes discussed include giant cell arteritis, trigeminal post-herpetic neuropathy, sleep apnea, cardiac cephalgia, cervicogenic pain, vascular etiologies, medications, and burning-mouth syndrome. In older individuals, primary headaches are diagnoses of exclusion, and treatment is affected by comorbidities and polypharmacy. Secondary headaches are a major consideration requiring appropriate workup. Many treatments can safely be offered regardless of age.

Efficacy and tolerability of a fixed dose combination of cortex phospholipid liposomes and cyanocobalamin for intramuscular use in peripheral neuropathies.

Peripheral neuropathies are frequently encountered in clinical practice and are associated with a major impairment in quality of life. However, their management remains poor, and current therapies are often burdened with major side effects and can present poor efficacy on pain and functionality. Therefore, it has been suggested that the combination of two or more different drugs may improve analgesic efficacy and reduce side effects. Tricortin® 1000 is formulated with 12 mg of Brain cortex phospholipid liposomes + 1000 µg of Cyanocobalamin injectable solution (PL+CNCbl) for intramuscular use and is indicated in the treatment of poly-algo-neuropathic syndromes. This combination exerts a marked neurotrophic action by promoting the synthesis of endogenous phospholipids; moreover, the peculiar formulation optimizes the delivery of CNCbl which has analgesic and neurotrophic action. This paper discusses the pharmacotherapy of peripheral neuropathies, including low-back pain, neck pain, postherpetic neuropathy (PHN) and focuses on the fixed dose combination PL+CNCbl clinical efficacy in association with other treatments or in monotherapy.

Scrambler therapy for the treatment of chronic post-mastectomy pain (cPMP) in breast cancer survivors.

253 Background: cPMP is chronic pain in the front thorax, axilla, and/or upper half of the arm beginning after mastectomy or lumpectomy persisting > 3 months after treatment and presents with pain, allodynia and disability. cPMP occurs in half of all patients with breast cancer and is severe in 13% (Gartner R JAMA 2009). Epidural bupivacaine, memantine, gabapentin or venlafaxine may help prevent cPMP, but there are no established proven treatments. (Shen J, Up to Date 2016) Scrambler therapy (ST) is an FDA-cleared treatment for neuropathic pain supported by multiple trials in over 800 patients with cancer pain, chemotherapy induced neuropathic pain, back pain, and post herpetic neuropathy (PHN). (Majithia N JSSC 2016) Methods: We treated 2 women with cPMP with standard ST, with repeated treatment if the pain returned. ST was done with ECG pads above and below the pain for 45 minutes daily, until pain resolved, and repeated if/when pain recurred. Results: Case 1: A 60 year-old woman had bilateral mastectomy 2 years prior with cPMP like “a barbed wire bra”. Before treatment, her pain was 8, which decreased to 0-2 after 5 treatments. Her pain returned 4 months later and was successfully retreated. She resumed a more normal life and was able to taper and eventually stop her opioids. Case 2: A 56 year-old woman had deep aching cPMP for a year following chemo, Mastectomy, and RT. Her pain was 10, decreased to 0-1/10. Her pain returned 1 month later; 3 treatments reduced her pain from 4/10 to 0/10 and improved her quality of life, which lasted for several months until cancer recurrence. Conclusions: Scrambler therapy successfully treated cPMP in 2 patients with improved pain and quality of life, and enabled one patient to stop her opioids in line with new CDC guidelines. Scrambler therapy appears to hold promise, as it does in chemotherapy-induced neuropathy, failed back syndrome, PHN, low back pain and other conditions; prospective trials are indicated to further evaluate this treatment modality. [Table: see text]

Herpes zoster und postzosterische Neuralgie

Herpes zoster develops by endogenous reactivation of varizella zoster virus (VZV). Incidence increases with age. Females are more frequently affected than males. The reactivation rate in seropositive individuals is about 20 %. After ashort prodromal stage, herpetiform-grouped vesicles appear in segmental arrangement. Pain and paresthesia are typical zoster symptoms. Complications like bacterial superinfections, vasculopathy, paresis, and oculopathy may occur. During pregnancy herpes zoster is athreat for mother and child. Among elderly patients, cardiovascular risk is increased during the first week of herpes zoster infection. Postherpetic neuropathy is feared. Diagnosis can be made clinically and by the use of polymerase chain reaction. First-line treatment is systemic antiviral drug therapy with either acyclovir or brivudine. Adjuvant therapies consist of pain management and topical treatment.

New physiological classification of pains: current concept of neuropathic pain

BACKGROUND AND OBJECTIVES Neuropathic is a complex entity and experts have tried to define it in a clearer and more objective way for its diagnosis to be more accurate, especially for non-specialists. Aiming at evaluating studies on the subject and their repercussion on medical practice, a systematic review was carried out from 2000 to 2016 on published studies about neuropathic pain, its definition and involved physiological aspects, using Pubmed, Cochrane and LILACS as databases. CONTENTS The new concept accepted by the International Association for the Study of Pain in 2011 considers neuropathic as pain induced by injury or disease directly affecting the system. So, dysfunction, considered a vague term, was replaced by disease, and nervous system was replaced by somatosensory system, to topographically delimit the disease. The new definition has created diagnoses based on clinical history and anatomic location, associated to evidential tests. Conditions such as diabetic polyneuropathy, post-herpetic neuropathy, compressive radiculopathy, other peripheral neuropathies and thalamic were well covered by new guidelines, however pains such as essential trigeminal neuralgia, fibromyalgia, complex regional syndrome type I, were excluded from the new definition. CONCLUSION Current concept is not ideal; it is limited and excludes major states and although the new classification has improved the understanding of neuropathic pain, further studies are needed on the subject.

Peripheral nerve field stimulation for trigeminal neuralgia, trigeminal neuropathic pain, and persistent idiopathic facial pain.

Peripheral nerve field stimulation (PNFS) is a promising modality for treatment of intractable facial pain. However, evidence is sparse. We are therefore presenting our experience with this technique in a small patient cohort. Records of 10 patients (five men, five women) with intractable facial pain who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation were retrospectively analyzed. Patients' data, including pain location, etiology, duration, previous treatments, long-term effects and complications, were evaluated. Four patients suffered from recurrent classical trigeminal neuralgia, one had classical trigeminal neuralgia and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, one from post-herpetic neuropathy, one from trigeminal neuropathy following radiation therapy and one from persistent idiopathic facial pain. Average patient age was 74.2 years (range 57-87), and average symptom duration was 10.6 years (range 2-17). Eight patients proceeded to implantation after successful trial. Average follow-up after implantation was 11.3 months (range 5-28). Using the visual analog scale, average pain intensity was 9.3 (range 7-10) preoperatively and 0.75 (range 0-3) postoperatively. Six patients reported absence of pain with stimulation; two had only slight constant pain without attacks. PNFS may be an effective treatment for refractory facial pain and yields high patient satisfaction.

Disabling Asterixis Induced By Gabapentin

We describe a case of an 80-year-old woman who developed disabling asterixis after taking gabapentin for post-herpetic neuropathy. She had end-stage renal disease necessitating intermittent hemodialysis for the previous 5 years. She had begun taking gabapentin about 1 week prior to being admitted to the hospital, and a family member observed a new tremor developing about 3 days prior to hospital admission. Neurologic examination revealed diffuse axial and appendicular negative myoclonus. Because of her renal dysfunction, the gabapentin dose was empirically reduced from 300 mg by mouth three times daily to 100 mg three times daily. Gabapentin was discontinued on hospital day 5 because of concerns for drug toxicity causing the abnormal movements. Two days after gabapentin was discontinued, she has complete resolution of her negative myoclonus. J Med Cases. 2015;6(7):285-286 doi: http://dx.doi.org/10.14740/jmc2143w

Treatment of Postherpetic Pain With Scrambler Therapy, a Patient-Specific Neurocutaneous Electrical Stimulation Device

Postherpetic neuropathy (PHN) is common, severe, and often refractory to treatment. We treated 10 patients with refractory PHN using Scrambler therapy, a neurocutaneous stimulation device that delivers "nonpain" information with surface electrodes. Scrambler therapy was given as 30-minute sessions daily for 10 days. Pain was recorded before and after treatment. Two centers. The average pain score rapidly diminished from 7.64 ± 1.46 at baseline to 0.42 ± 0.89 at 1 month, a 95% reduction, with continued relief at 2 and 3 months. Patients achieved maximum pain relief with less than 5 treatments. Scrambler therapy appears to have a promising effect on PHN, with prompt and continued relief and no side effects. Further research is warranted.

Treatment of post-herpetic pain with scrambler therapy, a patient-specific neuro-cutaneous electrical stimulation device.

e19564^ Background: Post herpetic neuropathy (PHN) is common in cancer and hematologic malignancy patients. It can be debilitating and difficulty to treat effectively. Scrambler therapy, a patient-specific neurocutaneous stimulation device, can be effective in treating chemotherapy induced neuropathy (JPSM 2010) and other neuropathic pain (JPSM 2012). Methods: We treated ten patients, 2 with cancer as their primary diagnosis, with refractory PHN Scrambler therapy at two institutions. Scrambler therapy was given as 30 minute sessions daily for 10 days. Pain was recorded before and after treatment. Results: The patient mean age was 54 ± SD 13 years, 6 men and 4 women, with a mean duration of PHN for 15.6 months (range 2.5 to 48 months) without satisfactory relief despite conventional drugs. The average pain score rapidly diminished from 7.64 ± 1.46 at baseline to 0.42 ± 0.89 at one month, a 95% reduction, with continued relief at 2 and 3 months. Patients achieved maximum pain relief with less than 5 treatments. Conclusions: Scrambler therapy appears to have a promising effect on PHN, with prompt and continued relief and no side effects. Further research is warranted. [Table: see text]

Topical capsaicin for the treatment of neuropathic pain

This review examines neuropathic pain, one of the most common and difficult to treat manifestations of chronic pain. Neuropathic pain follows damage to neural tissue, and can result from numerous causes and manifest in several ways. It can also persist long after any identifiable primary cause resolves. Conventional painkillers produce adequate analgesia in fewer than half of people suffering from neuropathic pain. In some cases, even opiates fail to induce adequate analgesia. Topical capsaicin is an effective treatment for postherpetic neuropathy, painful diabetic neuropathy, osteoarthritis, and rheumatoid arthritis. Nurses should counsel patients about the possibility of a burning sensation during initial treatment. Studies have shown that a single application of 8% capsaicin patch can reduce neuropathic pain for up to 12 weeks.

Effective Treatment of Post-Herpetic Neuropathy With Scrambler Therapy, Patient-Specific Neurocutaneous Electrical Stimulation (311-C)

1.Recognize the incidence and severity of post-herpetic neuralgia.2.Recognize the effectiveness of patient-specific neurocutaneous electrical stimulation with Scrambler Therapy. Post-herpetic neuropathy (PHN) or post-shingles pain affects at least 7%-19% of shingles patients with increasing frequency by age. To date, no therapy has been uniformly effective in either preventing or treating PHN. Therapies such as gabapentin, tricyclic antidepressants, or pregabalin plus transcutaneous electrical nerve stimulation (TENS) reduce pain in about one-third of patients but have side effects and require ongoing treatment. Scrambler therapy has been effective for refractory chemotherapy induced peripheral neuropathy and refractory neuropathic pain. To determine the effectiveness of Scrambler Therapy on PHN. Each person was treated for 30-45 minutes as an outpatient for 10 working days. The patients in Italy were treated with Scrambler Therapy on the randomized trial, and patients in Virginia were treated on an open access trial, MCC 13098. All patients gave informed written consent and all studies were approved by the relevant ethics board. We treated 10 patients with long standing established PHN and observed a dramatic reduction in pain. The patient mean age was 54 ± SD 13 years, 6 men and 4 women, with a mean duration of PHN for 15.6 months (range, 2.5-48 months) without satisfactory relief despite conventional drugs. Average pain score rapidly diminished from 7.64 ± 1.46 at baseline to 0.42 ± 0.89 at one month, a 95% reduction, with continued relief at 2 and 3 months. Patients achieved maximum pain relief with less than 5 treatments. Most patients were able to stop or reduce their pain medicines completely. Five of 10 patients had complete disappearance of pain which has continued. As in other trials of Scrambler Therapy, no side effects were observed.

The Concurrent Use of Gabapentin and Opioid Analgesia in Burns Patients

Dear Editor, I read with interest the study by Rimaz et al. (1) which showed a statistically significant reduction in visual analogue pain scores and morphine consumption in a double blind randomised setting with 25 patients in each wing. This is not the first study to suggest that in tackling the complex mechanism of post-burn hypersensitivity, as yet not fully understood but thought to be similar to post-operative pain hypersensitivity; analgesics with different but synergistic effects may prove superior to opioid analgesia alone (2, 3). Although in common use for neuropathic pain worldwide gabapentin has only relatively recently been taken up by plastic surgeons for use in acute burn pain both pre and post-surgical debridement. Although the study undoubtedly shows promising results in terms of a significant decrease in both pain scores and morphine consumption, there are some difficulties which must be addressed prior to gabapentin potentially becoming an accepted adjunct to opioid analgesia in the treatment of acute burns pain. As is often the case with the introduction of adjuvant drug treatment studies are difficult to compare due to the inherent variability of drug dosage, regimen, and use of adjuvant drugs and length of treatment. A similar study looking at the effects of gabapentin on morphine consumption in burns patients by Cuignet et al. (2), although reaching the same overall conclusions as Rimaz et al. (1) used a very different dosing regimen; a single dose of 1200mg gabapentin pre-operatively (1) and 2400mg daily from burn day 3-24 and results recorded for 21 days pre and post-surgical debridement (2) respectively. Additionally, in a further case series using gabapentin for acute burn pain Gray et al. (3) used regimens as varied as 1000mg four times per day with concurrent oxycodone and 300mg three times per day are described. Therefore although several studies have now shown gabapentin to be a beneficial addition to an opioid analgesia regimen in burns patients (1-3) what is required is collaborative research effort in order to determine the lowest possible dose of gabapentin to achieve maximal pain relief but with minimal side effects. This will allow a future systematic review with significant power to change recommended practice should future research continue to produce positive results. Although Rimaz et al. (1) found no side effects with the 1200mg single pre-operative dose of gabapentin, it must not be forgotten that gabapentin is a drug which can cause significant side effects even if only used for a short period of time, especially at the relatively high doses recommended by Cuignet et al. (2) Multicentre studies of gabapentin in post-herpetic neuralgia and painful diabetic neuropathy have shown significant side effects reporting day-time somnolence of up to 27% (4) and dizziness at 24% (5) which must be balanced with the potential analgesic benefit of gabapentin in burns patients. In the interests of burns patients world-wide is it hoped that further collaborative research will follow promptly to advance a treatment which, although currently in its infancy, has the potential to alleviate the significant pain that many such patients currently suffer.

Combination Therapy for Neuropathic Pain

Neuropathic pain is a debilitating chronic condition that remains very difficult to treat. Recently, a number of clinical studies have compared the effectiveness of combination drug therapy with monotherapy for neuropathic pain treatment. In this article, we summarize up-to-date clinical studies of combination therapy for the treatment of both cancer- and non-cancer-related neuropathic pain. Despite a relatively small number of clinical studies on this topic, several positive indications have emerged. First, clinical studies using gabapentin (five positive trials) and pregabalin (five positive trials and one negative trial) in combination with an opioid, cyclo-oxygenase-2 inhibitor or antidepressant have shown positive responses greater than the respective monotherapies for pain related to diabetic neuropathy and postherpetic neuropathy. Second, high-concentration (8%) topical capsaicin and a 5% lidocaine patch seem to be effective add-on therapies (a modality of combination therapy) for various neuropathic pain conditions. Third, combination therapy for cancer-related neuropathic pain has yielded only limited success based on a number of small-scale clinical studies. While there are benefits of using combination therapy for neuropathic pain treatment, including better pain relief and reduced adverse effects, more clinical studies are required in order to (i) make head-to-head comparisons between combination and single-drug therapies, (ii) identify symptom-specific combination therapies for distinctive clinical neuropathic pain conditions, (iii) explore combination therapies that include non-drug modalities such as physical therapy, psychological coping and biofeedback to facilitate functional restoration and (iv) develop new and objective evaluation tools for clinical outcome assessment.

Incidence and impact of pain conditions and comorbid illnesses

BackgroundIndividuals with pain often present with more than one painful condition. The purpose of this study was to characterize the rates of comorbidity, pain medication use, and health care costs for 23 selected pain conditions in a large health plan using administrative claims data from 2005 to 2007.MethodsEligible patients included 1,211,483 adults with at least one pain condition during the one-year study period. Pain condition cohorts were classified based on the first diagnosis present in the claims during the study period.ResultsMusculoskeletal pain conditions were among the most prevalent cohorts including low back pain, osteoarthritis, and fibromyalgia. Cancer pain was the least prevalent cohort. Conditions with the lowest illness severity included migraine and painful bladder syndrome cohorts, while cohorts with diabetic neuropathy, human immunodeficiency virus (HIV)-associated pain, and cancer pain were the most severe. Across cohorts, the mean number of comorbid pain conditions ranged from 1.39 (for cancer pain and migraine) to 2.65 (for multiple sclerosis pain). High rates of mental health conditions were found in cohorts with HIV-associated pain and multiple sclerosis pain (42.59% and 34.78%) and were lowest among cohorts with rheumatoid arthritis and psoriatic arthropathy (12.73% and 13.31%), respectively. Rates of sleep disorders ranged from 5.47% (for painful bladder syndrome) to 11.59% (for multiple sclerosis pain). Overall, patients averaged 3.53 unique pain medications during the study period. Considerable annual total health care costs were observed in the cancer pain cohort and the lowest costs were observed in the postherpetic neuropathy, surgically-induced pain, migraine, and irritable bowel syndrome cohorts. Costs attributed to pain were highest among the multiple sclerosis, HIV, and cancer pain cohorts. The highest pharmaceutical costs were observed in the HIV cohort.ConclusionThese findings underscore the heterogeneity of patients with pain in terms of burden of illness, costs to the health care system, and the complexity of commonly co-occurring disorders.

Impact of Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy on Health Care Costs

Impact of Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy on Health Care Costs

Understanding the impact of pain response on changes in function, quality of life, and sleep interference in patients with painful diabetic peripheral neuropathy and post-herpetic neuralgia treated with pregabalin

Treatment of peripheral neuropathic pain conditions can benefit from further understanding of the impact of pain response on activities of daily living and sleep. This study explores relationships between changes in diabetic peripheral neuropathy (DPN) and post herpetic neuropathy (PHN) pain, and changes from baseline to endpoint with pregabalin treatment on an 11-point pain numeric rating scale, Patient Global Impression of Change (PGIC), 36-Item Short Form Health Survey (SF-36), Medical Outcomes Study (MOS) Sleep scale, and Daily Sleep Interference (DSI) scale, an 11-point numeric rating scale using a daily diary. Data from 10 double-blind, placebo-controlled trials of pregabalin monotherapy (5-13 weeks) for painful DPN and PHN were pooled for this analysis. Percentage of pain reduction was assessed as: substantial improvement - ≥50% pain reduction; moderate - 30% to <50%; minimal - 15% to <30%; marginal - 0% to <15%. 54% of patients treated with pregabalin had moderate or substantial pain improvement vs. 31% of patients on placebo. In patients with substantial pain improvement, 80% reported “very much improved” or “much improved” on the PGIC, compared with 47% with moderate pain reduction, 31% with minimal pain reduction, and 10% with marginal pain reduction. Greater pain improvement was associated with higher scores on the SF-36 Social and Physical Function subscales. Sleep interference measured by the DSI decreased with increased pain response from baseline to endpoint: 4 points for patients with substantial pain improvement, 2.3 with moderate pain reduction, 1.7 with minimal reduction, and 0.9 for marginal reduction. Sleep problems as measured by the MOS overall sleep problem index and MOS sleep disturbance scale similarly decreased with increased pain response. Measurement of sleep disturbance improved to normal range for patients with substantial pain improvement. Greater pain reduction was associated with overall improvement in patients' function, quality of life, and sleep. (Supported by Pfizer Inc.) Treatment of peripheral neuropathic pain conditions can benefit from further understanding of the impact of pain response on activities of daily living and sleep. This study explores relationships between changes in diabetic peripheral neuropathy (DPN) and post herpetic neuropathy (PHN) pain, and changes from baseline to endpoint with pregabalin treatment on an 11-point pain numeric rating scale, Patient Global Impression of Change (PGIC), 36-Item Short Form Health Survey (SF-36), Medical Outcomes Study (MOS) Sleep scale, and Daily Sleep Interference (DSI) scale, an 11-point numeric rating scale using a daily diary. Data from 10 double-blind, placebo-controlled trials of pregabalin monotherapy (5-13 weeks) for painful DPN and PHN were pooled for this analysis. Percentage of pain reduction was assessed as: substantial improvement - ≥50% pain reduction; moderate - 30% to <50%; minimal - 15% to <30%; marginal - 0% to <15%. 54% of patients treated with pregabalin had moderate or substantial pain improvement vs. 31% of patients on placebo. In patients with substantial pain improvement, 80% reported “very much improved” or “much improved” on the PGIC, compared with 47% with moderate pain reduction, 31% with minimal pain reduction, and 10% with marginal pain reduction. Greater pain improvement was associated with higher scores on the SF-36 Social and Physical Function subscales. Sleep interference measured by the DSI decreased with increased pain response from baseline to endpoint: 4 points for patients with substantial pain improvement, 2.3 with moderate pain reduction, 1.7 with minimal reduction, and 0.9 for marginal reduction. Sleep problems as measured by the MOS overall sleep problem index and MOS sleep disturbance scale similarly decreased with increased pain response. Measurement of sleep disturbance improved to normal range for patients with substantial pain improvement. Greater pain reduction was associated with overall improvement in patients' function, quality of life, and sleep. (Supported by Pfizer Inc.)