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Epidemiology has long been a neglected aspect of clinical research related to neuropathic pain and until recently there was no reliable information regarding the general epidemiology of this type of pain, most notably its prevalence and incidence. Two large population-based postal surveys have been carried out to estimate the overall prevalence of chronic pain with neuropathic characteristics (NC) in the general population. The large epidemiological survey of the burden of illness due to chronic neuropathic pain was undertaken in the French general population. Assessment of quality of life in patients with or without pain was based on the Medical Outcome Short Form 12 scale (MOS-SF-12). The surveys have shown that all domains of quality of life, sleep duration, and quality and symptoms of depression and anxiety are consistently more impaired in subjects reporting chronic pain with NC than in subjects reporting chronic pain without NC.
This chapter describes the forms of assessment of neuropathic pain (NP) currently used in neuropathic pain therapeutic trials including intensity scales, specific and non-specific pain measurement questionnaires, and quantitative sensory testing (QST), with emphasis on their advantages and limitations. The lack of specificity of the McGill Pain Questionnaire (MPQ) and SF-MPQ for neuropathic pain has led to the development of various NP measurement scales that have been designed to evaluate separately the various symptoms of neuropathic pain. QST allows an assessment of sensory detection thresholds for innocuous stimuli and pain thresholds, generally using the method of limits, less commonly the method of levels. It also includes the assessment of sensations induced by sub-threshold or suprathreshold stimuli, which may contribute to the identification and quantification of hyperalgesia. Finally, the chapter summarizes and discusses prior recommendations about the use of these measures in clinical trials.
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