Neuropathic Pain, Neuropathic Pain Diagnostic Questionnaire (DN4) ≥ 4
Conditions
Keywords
Neuropathic Pain, Sympathetic Nerve, Inflammation
Brief summary
This prospective observational study aims to evaluate the relationship between hematological inflammatory indices and clinical treatment response in patients with neuropathic pain undergoing sympathetic nerve block procedures as part of routine clinical care. Hematological parameters including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and red cell distribution width (RDW) will be evaluated before and after treatment. The association between changes in these indices and pain outcomes will be analyzed.
Detailed description
Neuropathic pain is a complex chronic pain condition involving inflammatory, neural, and immune-mediated mechanisms. Increasing evidence suggests that systemic inflammatory processes may contribute to the pathophysiology and persistence of neuropathic pain. Hematological inflammatory indices derived from routine complete blood count parameters have recently emerged as inexpensive and accessible biomarkers reflecting systemic inflammatory status. Although several studies have investigated inflammatory markers in chronic pain syndromes, data regarding the relationship between hematological inflammatory indices and treatment response following sympathetic nerve block interventions in neuropathic pain are limited. This prospective observational study aims to evaluate whether hematological inflammatory indices are associated with treatment outcomes in neuropathic pain patients treated with sympathetic nerve block procedures as part of routine clinical management. Adult patients diagnosed with neuropathic pain and scheduled for sympathetic nerve block treatment will be prospectively followed for 3 months. Clinical outcomes including Numeric Rating Scale (NRS), DN4 and/or LANSS neuropathic pain scores, Global Perceived Effect (GPE), and analgesic consumption will be recorded. Hematological indices including NLR, PLR, MLR, SII, SIRI, AISI, and RDW will be calculated using routine hemogram parameters. The study is designed as a non-interventional, single-center, prospective observational clinical study. The treatment approach will not be altered for research purposes.
Interventions
None listed
Sponsors
Ankara City Hospital Bilkent
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * Diagnosis of neuropathic pain based on clinical evaluation * DN4 and/or LANSS scores compatible with neuropathic pain * Undergoing sympathetic nerve block as part of routine clinical treatment * Availability of pre-treatment and follow-up hemogram parameters * Ability to provide written informed consent
Exclusion criteria
* Age \<18 years * Active infection or acute inflammatory disease * Active malignancy * History of hematological disease * Immunosuppressive therapy or systemic corticosteroid use * Major surgery or severe trauma within the last month * Pregnancy or breastfeeding * Autoimmune or rheumatologic inflammatory disease * Missing follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment Response at Month 3 | 3 th month | Treatment response will be defined as achieving at least 50% reduction in Numeric Rating Scale (NRS) pain score compared with baseline. NRS 0 means = no pain NRS 10 means= worst pain imaginable |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NRS (Numeric Rating Scale Pain Score) | Baseline and 3rd month | Change in pain intensity measured by the 0-10 Numeric Rating Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. |
| Change in Hematological Inflammatory Indices | Baseline and 3rd monnth | Change in hematological inflammatory indices including NLR, PLR, MLR, SII, SIRI, AISI, and RDW from baseline to follow-up. |
| GPE (Global Perceived Effect) | 3rd month | Patient-reported global improvement after treatment assessed using the Global Perceived Effect scale.Patient-reported overall improvement after treatment assessed using a 7-point Global Perceived Effect scale. Scale Description: 1. = completely recovered 2. = much improved 3. = slightly improved 4. = unchanged 5. = slightly worsened 6. = much worsened 7. = worse than ever Minimum Value: 1 Maximum Value: 7 Interpretation: Lower scores indicate better clinical improvement. Time Frame: Month 3 |
Countries
Turkey (Türkiye)
Contacts
CONTACTÜlkü Sabuncu, Assoc prof
Outcome results
None listed