PubMed is a service of the U.S. National Library of Medicine that includes over 18 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources. This is a valuable resource that we can use to obtain information on peripheral neuropathy (PN). There are over 100 medical articles per month written on PN.

CUMULATIVE ANNOTATED BIBLIOGRAPHY

Of SELECTED ARTICLES from the NEUROPATHY LITERATURE 2009- 1/2012

 PERIPHERAL NEUROPATHY LITERATURE REVIEW ARCHIVE

 William B. Donovan MD writes the Peripheral Neuropathy Literature Review for Neuropathy Hope, the monthly newsletter of the Pacific Chapter of the Neuropathy Association (PCNA). He reviews approximately a hundred medical articles on peripheral neuropathy (PN) indexed by the National Library of Medicine (NLM) a month. Those articles that would appear to be most interesting to neuropathy patients are selected and summarized. They emphasize prevention, evidence-based treatment, alternative treatment and cutting edge research. The above summaries appearing over the past several years are included in this archive.

Each summarized article is preceded by a “PMID”, a unique PubMed Identification Number. In order to obtain more information on any particular summarized article, its PMID may be entered into the “for” search bar of PubMed—and then click “GO”. The PubMed website is available at:

www.ncbi.nlm.nih.gov/sites/entrez

 

Dr. Donovan has encouraged readers to familiarize themselves with this website—either on their own computer, or one belonging to a friend, or the public library. In this way they will be able to expand on the leads given in his column.

As an example, some of the PMIDs that can be entered include the following:

  • 18021866 (prevention of PN due to shingles);
  • 15616239 (promotion of nerve regeneration);
  • 17696592 (prevention of chemotherapy induced PN).

 Note: Dr. Donovan is a physician retired from the practice of chronic pain management. He is a PN patient and a member of the Monterey CA support groups.

  • 10850865 A Mayo Clinic study of non-diabetic lumbosacral radiculoplexus neuropathy, found to be similar to the diabetic form with nerve degeneration due to microvasculitis. This under-recognized multifocal disorder is characterized by weight loss and asymmetrical lower extremity findings: pain, allodynia weakness, atrophy, and autonomic features. It is responsive to intravenous corticosteroids.

 

  • 12722128 A detailed discussion from King Saud University of the medical literature and beneficial effects of the Indian herb Nigella Sativa (kalonji), including analgesia.

 

  • 12809967 Doctor E.L. Tobinick reports two cases of chronic, severe, cervical, discogenic pain whose necks he injected subcutaneously with etanercept (Enbrel®) that were pain-free at one year.

 

  • 15115710 A Swiss study of acute, severe sciatica pain, comparing subcutaneous etanercept (Enbrel®) in the treatment group with intravenous methylprednisolone (Medrol®) in the control group, found a statistically significant improvement in the treatment group.

 

  • 15265252 This retrospective uncontrolled study by Tobinick of 143 patients with chronic treatment-refractory disc-related pain, treated with etanercept (Enbrel®) 25mg.injected subcutaneously directly over the affected spine, revealed significant (p

 

  • 15616239 A study of acetyl-L-carnitine (ALC) 1000mg three times daily for 52 weeks with peripheral neuropathy patients found improvement in pain, vibratory sense and nerve regeneration.

 

  • 17065669 The SYDNEY 2 trial with distal symmetric neuropathy in diabetics found that alpha lipoic acid 600mg daily for 5 weeks decreased Total Symptom Score by over 50%.

 

  •  17696592 An Italian article reviewing experimental evidence of acetyl-L-Carnitine counteracting the neurotoxicity of cancer chemotherapy agents and promoting recovery of nerve conduction and elevation of pain threshold.

 

 

  • 17713854 An animal study from Trakya University showing decreased myelin sheath breakdown in diabetic sciatic nerves following treatment with Nigella Sativa.

 

  • 17875242 A study from Spain found that, compared to gabapentin (Neurontin®), pregabalin (Lyrica) was more cost-effective with greater and faster pain reduction.

 

  • 17883740 A Johns Hopkins study of neuropathic pain found over a third reduction in pain and increase in daytime activity with the use of transdermal fentanyl (Duragesic®).

 

  • 17885349 A Stanford study demonstrating decreased neuropathic pain in older more severe cases following intravenous lidocaine (Xylocaine®).

 

  • 17909094 Genetic research with nerve growth factor.
  • 17696592 An Italian article reviewing experimental evidence of acetyl-L-Carnitine counteracting the neurotoxicity of cancer chemotherapy agents and promoting recovery of nerve conduction and elevation of pain threshold.

 

  • 17914029   A study by CDC of adult diabetics showing PN to be associated with low levels of polyunsaturated fatty acid in the diet.

 

  • 17920770 Treatment of neuropathic pain with gabapentin (Neurontin®), pregabalin (Lyrica®), tricyclic antidepressants, dual uptake inhibitors, and lidocaine (Xylocaine®) patch.

 

  • 17943857 In a Cochrane Database study of 61 trials of antidepressants for neuropathic pain, it was concluded that venlafaxine (Effexor®) and tricyclic antidepressants are effective.

 

  • 17977931 Although we all know of PN cases who have claimed benefit from Anodyne® monochromatic infrared photo energy treatment, This TAMU double-blind, randomized, sham-controlled clinical trial failed to show significant benefit for sensory neuropathy.

 

  • 18021866 Prevention of shingles neuropathy.

 

  • 18050220 A review of tumor necrosis factor-alpha blocking agents in the treatment of nerve root pain associated with disc herniation, concluding that sciatica is caused by a combination of mechanical and chemical stimulation of the nerve root.

 

  • 18085141 A study from Sichuan demonstrating more post-herpetic pain alleviation from ear point taping and pressing combined with acupoint injection than Western medication.

 

  • 18178525 The ICE Study,”…the largest reported trial of any CIDP (chronic inflammatory demylinating polyradiculoneuropathy) treatment, shows the short-term and long-term efficacy and safety of IGIV-C (intravenous immune globulin) and supports use of IGIV-C as a therapy for CIDP.”

 

  • 18262450 a double-blind placebo-controlled study at King’s College Hospital found that controlled-release oxycodone (Oxycontin®) added to gabapentin (Neurontin®) reduces diabetic neuropathic pain by a third, and improves sleep quality.

 

  • 18403272 A UC Davis double blind, placebo- controlled crossover study of neuropathic pain demonstrated analgesic response to smoking 3.5% as well as 7% cannabis (marijuana).

 

  • 18413214 Venlafaxine (Effexor®) is a combination norepinephrine-serotonin uptake inhibitor like duloxetine (Cymbalta®), the latter approved for use with peripheral neuropathy by the FDA. This study found venlafaxine to be safe, effective and well tolerated as a treatment for the pain of distal symmetrical sensorimotor polyneuropathy.

 

  • 18474189 A review of mirror visual feed back (tricking oneself into seeing the unaffected body part on the affected side of the body) as a way of decreasing neuropathic pain and normalizing movement.

 

  • 18541884 A study at Mt. Sinai Medical Center found that the application of a high concentration capsaicin dermal patch desensitized cutaneous pain receptors in HIV-associated distal sensory neuropathy.

 

  • 18600579 A discussion from the University of Toronto of fish consumption, omega-3 polyunsaturated fatty acids and docosahexaenoic acid (DHA) in the prevention and treatment of neurological disorders.

 

  • 18636234   A meta-analysis by Wake Forest University demonstrated increased functionality and chronic neuropathic pain relief from the H-Wave device manufactured by Electronic Waveform Lab.
  • 18646102 A review of the treatment of meralgia paresthetica (pain in the lateral thigh) from Charring Cross Hospital revealed over 80% response to either injection with local anesthetic/corticosteroid, or surgery; however, another study reported a 69% spontaneous recovery, without treatment.

 

  • 18646138 This Johns Hopkins review of the Cochrane Data Base of 142 studies in respect to symmetrical diabetic peripheral neuropathy “…. failed to identify a single randomized controlled trial or any well designed prospective study controlling for the non-operated limb that showed improvements in predefined points after decompressive surgery.

 

  • 18660651 A review of recent studies indicating the role of tumor necrosis factor-alpha from the injured intervertebral disc as the cause of inflammation and decreased nerve conduction velocity in sciatica, and the possibility of the tnf-alpha blocker, etanercept (Enbrel®), reversing the progression of this process.

 

  • 18673529 An Oxford study of fibromyalgia and diabetic neuropathy showed at least 50% pain reduction over 12 weeks for duloxetine (Cymbalta®) compared to placebo.

 

  • 1868812 UC Santa Barbara study of Cannabis (marijuana) for neuropathic pain.

 

  • 18774507 This Johns Hopkins review of three randomized controlled studies of 776 pregabalin (Lyrica®) and 258 controls of painful diabetic peripheral neuropathy found over four times the likelihood of at least 50% improvement with the active drug.

 

  • 18796160   An Albert Einstein College of Medicine study of painful diabetic neuropathy showing over twice the response rate for pregabalin (Lyrica®) at 49%, compared with placebo.

 

  • 18940920   A summary of studies done showing decreased pain and increased nerve regeneration in diabetic PN with acetyl-L-carnitine.

 

  • 19004197   A Guangzhou University study comparing the effectiveness of acupuncture plus acupoint-injection vs. oral carbamazepine (Tegretol®), for occipital neuralgia, with the former being more effective.
  • 19027875 A descriptive article written by E.L. Tobinick, the physician who patented a technique involving the injection of etanercept (Enbrel®) subcutaneously over the spine, thence absorbed into the cerebrospinal venous plexus, resulting in the inhibition of tumor necrosis factor, which is hypothesized to cause intervertebral disc- related pain.

 

  • 19141719 A randomized study of diabetic neuropathy patients, 89 treatment cases and 78 controls, demonstrated that silicon orthotics protected the feet from the development of painful hyperkeratotic lesions.

 

  • 19160200 Cochrane Database study of effectiveness of IVIg for CIDP

 

  • 19208243 Meta-analysis of duloxetine (Cymbalta®) vs. pregabalin (Lyrica®) for peripheral neuropathy.

 

  • 19224814 An evaluation of lidocaine (Xylocaine®) 8% spray for post-traumatic peripheral neuropathy found significant pain relief.

 

  • 19242524 Recent research has been exploring the possibility of transporting analgesic chemicals to the dorsal horn of the spinal cord, where the peripheral pain nerves enter the central nervous system. In order to transport these chemicals—enkephalin, endorphin, glutamic acid decarboxylase—rats have been infected with genetically engineered, non-replicating herpes simplex virus, which typically resides in the nerves of the dorsal horn. This complex, novel approach was reported to be safe in human trials at the 2011 meeting of the American Academy of Neurology.

 

  • 19246421 In a double blind crossover study in Taipei of botulinum toxin type A for diabetic neuropathy, there was significant improvement at 3 months post-injection.

 

  • 19252116 Mayo study of shingles prevention with anti herpes zoster vaccine

 

  • 19277838 An Italian study of CT-guided pudendal nerve block for pudendal neuralgia achieved relief of anoperineal pain, 92% at 12 months.

 

  • 19243312   A University of Leicester review of studies demonstrating prevention and amelioration of diabetic neuropathy with proinsulin C-peptide.
  • 19301378 An extensive Columbia University review of chronic demylinating polyradiculoneuropathy (CIDP), emphasized well-documented response to IVIg, plasmapheresis and corticosteroids—as well as lesser evidence supporting other agents: cyclophosphamide, rituximab, azothioprine, cyclosporine, interferon, fludarabine, mycophenolate, mofatil, and etanercept.

 

  • 19301937   A study from the University of Schleswig- Holstein comparing oral pregabalin (Lyrica®) with lidocaine (Xylocaine®) 5% medicated plaster found that the efficacy was comparable, but there were 90% fewer adverse events with the local treatment.

 

  • 19317819 A Japanese study of diabetic patients found that those with neuropathy had increased levels of vascular endothelial growth factor (VEGF), the same agent that is involved in diabetic retinopathy and wet age-related macular degeneration.

 

  • 19387178   A Johns Hopkins study of sciatica showing at least a 50% reduction in pain for the majority of patients at six months following nerve root injection with etanercept (Enbrel®).

 

  • 19406920 A study of over 5000 participants from community surveys in Singapore demonstrated that peripheral neuropathy incidence increased gradually with the level of fasting blood sugar, even at levels below the threshold for diabetes mellitus diagnosis.

 

  • 19432499 In a double-blind placebo-controlled multinational trial with post-herpetic neuralgia, improvement of pain, allodynia, quality of life and sleep was achieved with 5% lidocaine (Xylocaine®) plaster applied up to 12 hours daily.

 

  • 19499849 A Neapolitan study of 112 with carpal tunnel syndrome revealed significant improvement in symptoms and function when multivitamin controls were compared with a combination of alpha-lipoic acid 600mg. plus gamma-linolenic acid 360mg. daily.

 

  • 19555786 Chronic abdominal wall pain due to peripheral nerve impingement, often mistaken for intra-abdominal pathology, can be diagnosed by local anesthetic block of trigger points, and relieved by surgically releasing the nerve that is trapped by the muscle sheath.

 

  • 19557864 It is hypothesized that reflex sympathetic dystrophy, now known as complex regional pain syndrome (pain, hypersensitivity, sweat, edema, discoloration), may be a posttraumatic small fiber peripheral neuropathy.

 

  • 19588419 A review of the University of Oxford of 19 randomized control trials of pregabalin (Lyrica®) 600mg daily showed a minimum number of patients needed to treat (NNT), to achieve at least 50% pain relief was 5.6 for diabetic neuropathy and 5.0 for post-herpetic neuralgia.

 

  • 19590482 A study from Taiwan of carpal tunnel syndrome (wrist pain) showed no difference between those treated with corticosteroid and those receiving acupuncture.

 

  • 19655114 An extremely detailed monograph outlining possible mechanisms whereby nerve injury results in chronic pain—mediated by neuroinflammation, release of inflammatory cytokines, followed by hypersensitivity of the dorsal root ganglia, peripherally and later centrally in the dorsal horn of the spinal cord. Possible intervention using cytokine antibodies, e.g., anti- tumor necrosis factor alpha, is suggested.

 

  • 19703730 An Australian study of the local application of 10% Ketamine cream (NMDA antagonist) in patients with complex regional pain syndrome, inhibited allodynia (painful response to non-pain stimuli).

 

  • 19796802 This study at Queen’s University, Ontario, found that the antidepressant nortriptyline (Pamelor®) in combination with the anticonvulsant gabapentin (Neurontin®) controlled neuropathic pain more effectively than either medication alone.

 

  • 19801049 Under the auspices of the International Association for the Study of Pain, a consensus process developed evidence-based guidelines for the management of neuropathic pain, recommending tricyclic and dual uptake inhibitors of serotonin and norepinephrine, e.g., duloxetine (Cymbalta®), gabapentin (Neurontin®) and pregabalin (Lyrica®), and topical lidocaine (Xylocaine®) as first line treatments for neuropathic pain.

 

  • 19821395 A Cochrane database review of controlled trials of 2,220 patients prescribed duloxetine (Cymbalta®) for neuropathic pain (both neuropathy and fibromyalgia) found “moderately strong” evidence of effectiveness for doses between 60 mg. and 120 mg. daily.

 

  • 19921145 A randomized, controlled study of diabetics with varying degrees of peripheral neuropathy were given twice weekly physiotherapeutic group training in gait and balance exercises as well as function-oriented strengthening over twelve weeks. At six months there was significant improvement in balance, gait, mobility and strength

 

  • 20113411 A randomized double-blind, controlled study of post-herpetic neuralgia (shingles) comparing an 8% capsaicin dermal patch with a 0.04% control, found change in pain score of –33.8% compared to +4.9% at the end of twelve weeks.

 

  • 202236172 A double blind randomized controlled study of pregabalin (Lyrica®) 150-600 mg. daily found significant improvement in pain-related sleep interference (p < 0.001) with relief of post-traumatic peripheral neuropathic pain.

 

  • 20447305 A randomized, double blind, placebo-controlled trial of agmatine sulfate (decarboxylated amino acid arginine) 2.670 gm. daily for 14 days in cases of painful lumbar disc-associated radiculopathy, demonstrated significant improvement in pain and quality of life.

 

  • 20458651 A review of 23 studies of 5% lidocaine (Xylocaine®) medicated plaster to manage painful diabetic peripheral neuropathy, found fewer adverse events, but comparable effectiveness compared with amitriptyline (Elavil®), capsaicin, gabapentin (Neurontin®), and pregabalin (Lyrica®). 

 

  • 20460982 This article from Cook County Hospital describes paraneoplastic neurological syndrome, including peripheral neuropathy, which can occur as a result of occult cancer.

 

  • 20487567 This is a double blind randomized placebo controlled study from Louisiana State University assessing the topical oil, Neuragen PN®, in the treatment of neuropathic pain. Neuragen PN® resulted in significantly greater pain reduction (p < 0.05). 93.3% of treated patients compared to controls experienced pain relief within 30 minutes.

 

  • 20503464 An LSU study of 25 peripheral neurology patients over a 24 week course of tai chi instruction, found large improvement in plantar sensation, 6 minute walk, timed up and go, and leg strength.

 

  • 20594588 The 77 site ACCORD controlled study of Type2 diabetes found that tighter control of blood sugar (HbA1c targetimprovement in light touch and ankle jerk in those with peripheral neuropathy.

 

  • 20599049 A randomized double blind, sham-controlled study of magnetic disks applied for six weeks to the wrists of carpal tunnel syndrome patients, showed no statistically significant benefit in terms of nerve conduction or pain.

 

  • 20805210 A study from McGill University of posttraumatic or post-surgical patients with chronic neuropathic pain. A 25 mg dose of 9.4% smoked THC (marijuana) resulted in improved quality of sleep and decreased time to get to sleep. Adverse effects included cough, dry eyes, burning sensations, numbness and dizziness.

 

  • 20921842 This article discusses duloxetine (Cymbalta®) an antidepressant that blocks the reuptake of both norepinephrine and serotonin, and is approved by the FDA for treatment of peripheral neuropathy. Probable mechanism of action is the facilitation of descending pain inhibition pathways. Relief of other painful conditions, including fibromyalgia, has also been achieved.

 

  • 21127770 This article reminds us that Lyme disease, following a tick bite, and typically presenting with an expanding rash and arthritis, is a multisystem infection often causing painful neuropathies of both the cranial and peripheral nerves.

 

  • 21134121 According to a randomized controlled study of botulinum toxin (Botox®) injection for post-herpetic neuralgia (shingles), both pain and insomnia improved significantly. Opiate usage dropped 21% in the treatment group compared to the placebo group, which remained between 53-67%.

 

  • 21321947 Although previously thought to be due to thiamine deficiency, alcohol neuropathy is not reversible by vitamin B1, and, therefore, should be considered a toxic neuropathy.

 

  • 21336050 A Mayo Clinic study of transcranial magnetic stimulation of skull over the right dorsolateral prefrontal cortex of 9 subjects with refractory neuropathic pain, found that over a third had at least 50% reduction in pain. rTMS is being used more commonly for clinical depression. These patients had an average pain rating of 7.3, but no significant depression.

 

  • 21372279 A review of nine reports, 69 patients, receiving local anesthetic and corticosteroid nerve blocks for neuralgia, with 30 achieving complete pain relief, and 10 over 50% relief.

 

  • 21412914 This Cochrane Data Base review of 14 studies with 2831 patients evaluated gabapentin (Neurontin®) treatment of chronic neuropathic pain. Compared to placebo (17%), “substantial benefit” was achieved with 31%. Withdrawal from the study due to adverse event occurred in 12%.

 

  • 21719618 This study compared duloxetine (Cymbalta®) with pregabalin (Lyrica®) in the treatment of peripheral neuropathy pain in diabetics unresponsive to gabapentin (Neurontin®). Duloxetine was not statistically more effective than pregabalin. Side effects with duloxetine included insomnia, sweating, and appetite loss; pregabalin side effect was peripheral edema.

 

  • 21814197 A Mayo Clinic article reviewing therapy of chemotherapy-induced peripheral neuropathy (CIPN). The strongest evidence for prevention supports the use of intravenous calcium, magnesium and glutathione. The most effective agents for treatment appear to be serotonin/norepinephrine reuptake inhibitors.
    • 21998121 This is a randomized, controlled study of patients with acute sciatica. In the group treated with two subcutaneous injections of adalimubab (a tumor necrosis factor, alpha), 28% required surgery within three years, whereas 56% 0f the control group required surgery.

     

    • 22050401 This Kuwaiti study found that those Type 2 diabetics with peripheral neuropathy had significantly lower vitamin D levels than those without. Further study assessing vitamin D as a preventive is suggested.

     

    • 22133325 This review article presents evidence from a number of studies revealing significantly increased relief of neuropathic pain from a pairing of either gabapentin (Neurontin®) or pregabalin (Lyrica®), and an opioid, cox inhibitor, or antidepressant—greater than could be achieved with any of these agents singly.