Clinical phenotyping of postherpetic neuralgia patients to optimize pain treatment.

Recruiting

Conditions: pain after shingles
postherpetic neuralgia
10034606

Registration Number: NL-OMON54722

Lead Sponsor: niversitair Medisch Centrum Utrecht

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 200

Inclusion Criteria

- Aged 18 years or older.
- Diagnosed by a physicians with a herpes zoster skin rash.
- Pain in the dermatomes involved in the original eruption of herpes zoster.
- Able and willing to give written informed consent

Exclusion Criteria

- Patients with previous neurolytic or neurosurgical treatment for PHN.
(Radiofrequency treatment of the DRG is allowed).
- Patients receiving pain treatment by topical capsaicin 8% in the last 6
months
- Patients who have other types of pain, which could confound the assessment of
the neuropathic pain due to PHN.
- Patients with polyneuropathy or severe other neurologic disease that might
affect outcome measures.
- Patients with skin conditions in the area affected by the neuralgia that
could alter sensation.
- Patients with major cognitive or psychiatric disorders.
- Problems with communication (language, deafness, aphasia etc.)

Study & Design

Study Type: Observational invasive

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>Main study parameters/endpoints: The main study parameters are immunological<br /><br>and metabolic parameters in plasma and CSF, skin nerve fiber density<br /><br>measurements, questionnaires, and QST. We will determine whether the addition<br /><br>of these main study parameters identifies other/additional clinical phenotypes<br /><br>than those identified with QST alone and with which minimal parameter datasets<br /><br>these subsets can be identified. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>The secondary endpoint is effect of standard pain treatment for PHN within<br /><br>patient groups with the different clinical phenotypes expressed as decrease in<br /><br>numeric rating scale (NRS), global perceived effect (GPE), time to treatment<br /><br>effect, regain of function, quality of life and improvement of QST parameters<br /><br>assessed at one year follow up. Spinal immunological parameters and metabolites<br /><br>will be assessed with MRS in a subset of patients who provided additional<br /><br>informed consent. Individual methadone metabolism is assessed by determining<br /><br>CYP2B6 enzyme polymorphisms. </p><br>