OBJECTIVE: Although the presence of neuropathic pain (NP) components has been reported in whiplash-associated disorders (WAD), no studies have analyzed the usefulness of NP screening questionnaires to detect NP components in WAD. This study aimed to assess the usefulness of 3 NP screening tools (Douleur Neuropathique 4 [DN4], self-administered Leeds Assessment of Neuropathic Symptoms and Signs [S-LANSS], and painDETECT questionnaire [PDQ]) to detect the presence of NP components in acute WAD.
METHODS: A cross-sectional study.
METHODS: Hospital.
METHODS: Of 188 eligible individuals, 50 people (68% women, mean age = 40.3 ± 12.5 years) with acute WAD (52% Grade III) were included.
METHODS: Specialized physicians initially screened participants for the presence of NP components according to clinical practice and international recommendations. After physician assessment, blinded investigators used NP screening questionnaires (DN4, S-LANSS, and PDQ) to assess participants within 2 weeks of their accident. The diagnostic accuracy of these tools was analyzed and compared with the reference standard (physicians\' assessments).
RESULTS: The 3 screening questionnaires showed excellent discriminant validity (area under the curve: ≥0.8), especially S-LANSS (area under the curve: 0.9; P < .001). DN4 demonstrated the highest sensitivity (87%), followed by S-LANSS (75%), while S-LANSS and PDQ showed the highest specificity (85% and 82%, respectively). These tools demonstrated a strong correlation with the reference standard (S-LANSS: rho = 0.7; PDQ: rho = 0.62; DN4: rho = 0.7; all, P < .001).
CONCLUSIONS: The DN4, S-LANSS, and PDQ show excellent discriminant validity to detect the presence of NP components in acute WAD, especially S-LANSS. Initial screening with these tools might improve management of WAD.

This study aimed to analyze correlations between Self-Report Leeds Assessment of Neuropathic Symptoms (S-LANSS) and PainDETECT with proxies of sensitization, pain-related, or psychological/cognitive variables in coronavirus disease, 2019 (COVID-19) survivors exhibiting post-COVID pain. Demographic, clinical, psychological, cognitive, sensitization-associated symptoms, and health-related quality of life were collected in 146 survivors with post-COVID pain. The PainDETECT and S-LANSS questionnaires were used for assessing neuropathic pain-related symptoms. Patients were assessed with a mean of 18.8 (SD 1.8) months after hospitalization. Both questionnaires were positively associated with pain intensity (p < 0.05), anxiety (PainDETECT p < 0.05; S-LANSS p < 0.01), sensitization-associated symptoms (p < 0.01), catastrophism (p < 0.01), and kinesiophobia (p < 0.01) and negatively associated with quality of life (PainDETECT p < 0.05; S-LANSS p < 0.01). Depressive levels were associated with S-LANSS (p < 0.05) but not with PainDETECT. The stepwise regression analyses revealed that 47.2% of S-LANSS was explained by PainDETECT (44.6%), post-COVID pain symptoms duration (1.7%), and weight (1.1%), whereas 51.2% of PainDETECT was explained by S-LANSS (44.6%), sensitization-associated symptoms (5.4%), and anxiety levels (1.2%). A good convergent association between S-LANSS and PainDETECT was found. Additionally, S-LANSS was associated with symptom duration and weight whereas PainDETECT was associated with sensitization-associated symptoms and anxiety levels, suggesting that the two questionnaires evaluate different aspects of the neuropathic pain spectrum in post-COVID pain patients.

Aims: The aim of this study was to define the sensory phenotypes of taxane-induced peripheral neuropathy (TIPN) between neuropathic and nonneuropathic symptoms in a breast cancer population to identify future targets for mechanism-based pain management. Methods: Participants (n = 48) with stage I-III breast cancer. Self-report questionnaires and quantitative sensory testing were used to assess sensory symptoms. The self-report version of the Leeds Assessment for Neuropathic Symptoms and Signs (S-LANSS) divided the groups into neuropathic and nonneuropathic sensory phenotypes. In total, five visits over approximately 8 months assessed each participant from pre-chemotherapy to 6 months post-chemotherapy. Results: Out of 191 nerve assessments, 150 had an S-LANSS <12 defined as \"nonneuropathic\" and 41 scored >12, which was defined as \"neuropathic.\" Numeric Pain Rating Scale (NPRS) was analyzed based on percentages of those experiencing 1+ pain (graded 1/10 or higher) versus no pain. The neuropathic group had 82.9% of 1+ pain vs. 28.7% in the nonneuropathic group (odds ratio = 7.49; 95% confidence interval, 2.76-20.3; P = 0.001). The neuropathic group reported impaired function on the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire (P = 0.002). Heat pain threshold resulted in statistical differences for the left hand but not the right hand in the neuropathic group (P = 0.05). No other quantitative data on warm/cool or cold or vibration demonstrated sensory differences between the groups. Conclusions: Few differences in sensory profiles measured using quantitative sensory testing (QST) were found. Heat pain thresholds were normalized, possibly suggesting that the neuropathic group retained C-fiber and transient potential vanilloid 1 (TRPV1) function. Participants with neuropathic pain demonstrated significant differences with increased pain and decreased function.
Objectif: Déterminer les phénotypes sensoriels associés à la neuropathie périphérique induite par le taxane dans une population de personnes atteintes de cancer du sein, selon qu’elles présentent des symptômes de neuropathie ou non, afin de déterminer les cibles futures pour la prise en charge de la douleur axée sur les mécanismes.Méthodes: Participants (n = 48) atteints d’un cancer du sein de stade I-III. Des questionnaires d’auto-évaluation et des tests sensoriels quantitatifs ont été utilisés pour évaluer les symptômes sensoriels. À l’aide de la version d’auto-évaluation de l’outil d’évaluation des symptômes et des signes de la douleur neuropathique de Leeds (S-LANSS), les groupes ont été divisés en phénotypes sensoriels avec neuropathie et sans neuropathie. Au total, cinq visites échelonnées sur une période d’environ huit mois ont permis d’évaluer chaque participant avant le début de la chimiothérapie jusqu’à six mois après le début de celle-ci.Résultats: 191 évaluations des nerfs, parmi lesquelles 150 participantes ont obtenu une note < 12 pour le S-LANSS, définis comme «sans neuropathie », tandis que 41 participantes ont obtenu une note > 12, définie comme « avec neuropathie ». L’échelle numérique d’évaluation de la douleur a été analysée sur la base du pourcentage de participantes éprouvant une douleur égale ou supérieure à 1 (note de 1/10 ou plus) comparativement à aucune douleur. 82,9 % des patientes du groupe avec neuropathie éprouvaient une douleur égale ou supérieure à 1 comparativement à 28,7% pour le groupe sans neuropathie (RR = 7,49, CI 95 % 2,76-20,3, p = 0,001). Le groupe avec neuropathie a fait état d’une altération du fonctionnement selon le questionnaire DASH (p = 0,002). Des différences significatives ont été observées en ce qui concerne le seuil de la douleur thermique pour la main gauche, mais pas pour la main droite dans le groupe avec neuropathie (p = 0,05). Aucune autre donnée quantitative portant sur la sensibilité aux températures chaudes, tièdes ou froides, ou encore à la vibration, n’a révélé de différences sensorielles entre les groupes.Conclusions: On a constaté peu de différences entre les profils sensoriels mesurés par les tests sensoriels qualitatifs. Les seuils de douleur thermique ont été normalisés, ce qui indique probablement le maintien du fonctionnement des fibres de C et du TRPV1 chez le groupe avec neuropathie. Des différences significatives ont été observées chez les personnes souffrant de douleur neuropathique, dont une augmentation de la douleur et une diminution du fonctionnement.

The aim of this study was to culturally adapt and validate Leeds assessment of neuropathic symptoms and signs (LANSS) and self-report LANSS (S-LANSS) tools. Patients with chronic pain (n = 206) were categorized into neuropathic pain (NeP) (n = 101) or non-NeP (n = 105). After the translation process, both questionnaires and the Persian Douleur Neuropathique 4 (P-DN4) were administered to patients to assess the clinometric properties. The mean overall score of both tools was significantly higher in the NeP group (p < 0.01). Test-retest reliability analysis of the overall score of the Persian (P)-LANSS and PS-LANSS were 0.99 and 0.98, respectively. α-Cronbach value for P-LANSS and PS-LANSS were 0.64 and 0.61, respectively. Factor analysis of both questionnaires yielded two components explaining most of the observable variance. The P-LANSS was significantly correlated with PS-LANSS and P-DN4 (ρ = 0.92, p = 0.01, for both). PS-LANSS was also significantly correlated with P-DN4 (ρ = 0.79, p = 0.01). Both tools successfully diagnosed NeP patients at the cutoff point of ≥12 with 88.12% sensitivity and 76.19% specificity for P-LANSS and 83.17% sensitivity and 95.24% specificity for PS-LANSS. P-LANSS and PS-LANSS are reliable and valid tools to identify NeP component in chronic pain patients. PS-LANSS was found to be an acceptable alternative for P-LANSS.

OBJECTIVE: Tumor-related cancer pain often comprises mixed pain with both nociceptive and neuropathic components. Whether tumor-related cancer pain includes a neuropathic component impacts the therapeutic strategy. The aim of this cross-sectional study was to investigate the usefulness of two screening tools for neuropathic pain, painDETECT and Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), in identifying the neuropathic component of mixed pain among patients with tumor-related cancer pain.
METHODS: This cross-sectional study recruited consecutive inpatients and outpatients at a single site. The diagnostic accuracy of painDETECT and S-LANSS was evaluated using receiver operating characteristic curve analysis and classification probability.
RESULTS: Of the study group, 106 patients had tumor-related cancer pain. Analyses of the nociceptive and mixed pain groups (n = 104) showed that neither painDETECT nor S-LANSS had satisfactory areas under the curve (AUCs) for identifying the neuropathic component of mixed pain (0.59 for painDETECT and 0.56 for S-LANSS). By pain intensity, the AUC for painDETECT was significantly higher in the mild pain group than in the moderate or severe pain group (0.77 vs. 0.43, P = 0.002). All parameters of classification probability for both tools were higher in the mild pain group than in the moderate or severe pain group.
CONCLUSIONS: painDETECT and S-LANSS could not identify the neuropathic component of mixed pain among patients with tumor-related cancer pain, especially when pain was moderate or severe. Contrarily, these screening tools might be useful for identifying the neuropathic component of mixed pain for mild pain.

The LANSS and S-LANSS questionnaires represent two widely accepted and validated instruments used to assist the identification of neuropathic pain worldwide.
The aim of this study was to translate, culturally adapt, and validate the LANSS and S-LANSS questionnaires into the Greek language.
Forward and backward translations of both questionnaires were performed from the English to Greek language. The final versions were assessed by a committee of clinical experts, and they were then pilot-tested in 20 patients with chronic pain. Both questionnaires were validated in 200 patients with chronic pain (100 patients for each questionnaire), using as the \"gold standard\" the diagnosis of a clinical expert in pain management. Sensitivity and specificity of questionnaires were assessed, as well as the internal consistency (using Cronbach\'s alpha coefficient) and correlation with the \"gold standard\" diagnosis (using Pearson correlation coefficient).
Sensitivity and specificity of the LANSS questionnaire were calculated to be 82.76% and 95.24%, while for the S-LANSS 86.21% and 95.24%, respectively. Positive predictive value for neuropathic pain was 96% for the LANSS and 96.15% for the S-LANSS. Cronbach\'s alpha was revealed to be acceptable for both questionnaires (0.65 for LANSS and 0.67 for the S-LANSS), while a significant correlation was observed compared to the \"gold standard\" diagnosis (rLANSS   = 0.79 και tSLANSS   = 0.77, respectively, P = 0.01).
The LANSS and the S-LANSS diagnostic tools have been translated and validated into the Greek language and can be adequately used to assist the identification of neuropathic pain in everyday clinical practice.

The EQ-5D and Short Form (SF)12 are widely used generic health-related quality of life (HRQoL) questionnaires. They can be used to derive health utility index scores, on a scale where 0 is equivalent to death and 1 represents full health, with scores less than zero representing states \"worse than death.\" We compared EQ-5D or SF-6D health utility index scores in patients with no chronic pain, and chronic pain with and without neuropathic characteristics (NC), and to explore their discriminant ability for pain severity. Self-reported health and chronic pain status was collected as part of a UK general population survey (n=4451). We found moderate agreement between individual dimensions of EQ-5D and SF-6D, with most highly correlated dimensions found for mental health and anxiety/depression, role limitations and usual activities, and pain and pain/discomfort. Overall 43% reported full health on the EQ-5D, compared with only 4.2% on the SF-6D. There were significant differences in mean utilities for chronic pain with NC (EQ-5D 0.47 vs SF-6D 0.62) and especially for severe pain (EQ-5D 0.33 vs SF-6D 0.58). On the EQ-5D, 17% of those with chronic pain with NC and 3% without NC scored \"worse than death,\" a state which is not possible using the SF-6D. Health utilities derived from EQ-5D and SF-12/36 can discriminate between group differences for chronic pain with and without NC and greater pain severity. However, the instruments generate widely differing HRQoL scores for the same patient groups. The choice between using the EQ-5D or SF-6D matters greatly when estimating the burden of disease.

Postherpetic neuralgia (PHN) is one of the most severe sequelae of herpes zoster events. Several risk factors have been reported for PHN, including old age, severe skin rash, and intense pain. This study therefore aims to evaluate the usefulness of the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) in conjunction with previously reported risk factors for predicting PHN. A group of herpes zoster patients (N = 305) were included in the cohort study. Subjects were asked for their demographic information, clinical symptoms and signs, intensity of pain by visual analog scale (VAS), and S-LANSS. They were followed up in clinical visits or via telephone for 12 months. Nineteen patients (6.2%) suffered from PHN in this study. Using logistic regression, 3 risk factors for PHN were identified: age ≥70 years, high VAS scores, and high S-LANSS scores. Prediction of PHN using VAS (≥8) and S-LANSS (≥15) criteria achieved a sensitivity of 78.9% and specificity of 78.0%. Prediction of PHN in elderly patients (≥70 years), using the criteria of VAS (≥6) and S-LANSS (≥15) as well, achieved 100% sensitivity and 57.1% specificity. S-LANSS could be a useful prediction tool for PHN, particularly if combined with previously well-known risk factors and VAS.
CONCLUSIONS: Among acute herpes zoster patients, subjects with characteristics of neuropathic pain showed high frequency of PHN. The tools for screening neuropathic pain like S-LANSS could be helpful for predicting PHN and enabling early intervention of pain management.