Leprosy

projects 2008-2012

The development of new tools for the investigation of neuropathic pain in leprosy: a pilot study in Mumbai, India

Principal Investigator Prof. Diana Lockwood

Collaborators London School of Hygiene & Tropical Medicine (LSHTM) [Diana Lockwood and Dr. Omer Haroun (LSHMT), Prof. Andrew Rice (CO PI) (Imperial College London)]

Project team Dr. Vanaja P Shetty (Co PI), Dr. Ashish Khodke

Funder The Hospital & Homes of St. Giles (HHSG),UK

Duration July 2012 to October 2013

Budget Rs.4.97 Lakhs

Background

The overall aim of the study is to characterize the somatosensory phenotype of leprosy patients with chronic neuropathic pain.

Available data are far from satisfactory to understand the exact path-physiological related mechanisms of neuropathic pain in leprosy patients. Patients with painful neuropathy have impaired thermal and mechanical thresholds. Neuropathic pain has a higher impact on quality of life and psychological well being compared to pain-free neuropathy in leprosy patients. Therefore there is a pressing need to conduct studies to better understand the exact mechanisms of leprosy neuropathy and to design reasonable preventive and therapeutic modalities for chronic neuropathic pain in leprosy.

In this study we propose to assess somatosensory phenotype in leprosy patients with neuropathic pain using two tools: quantitative sensory testing (QST) and Intra-Epidermal Nerve Fibre density (IENF). There have been few studies examining both of these among leprosy patients.

Objectives

  • To assess the somatosensory phenotype in leprosy patients using Quantitative Sensory Testing (QST) tool.
  • To determine the density of Intraepidermal nerve fibre in leprosy patients.
  • To determine the correlation between leprosy pain modalities and peripheral sensory dysfunction, IENFD, psychological co-morbidity and quality of life.
  • Expected outcomes: It is estimated that around 20% of leprosy patients suffer from pain associated with nerve damage known as leprosy related sensory neuropathy. The exact patho-physiological related mechanism/s of neuropathic pain in leprosy patients remain unclear. This study will help in assessment of neuropathic pain and may be able to inform design of appropriate diagnostic and assessment tools for routine clinical use in leprosy related neuropathic pain. It also adds to our knowledge the relationship between pain and cutaneous innervations abnormalities in leprosy. In addition identify the specific impact of different aspect of pain on quality of life and physiological well-being of, in the context of leprosy.
  • Measures of neuropathic pain impact on leprosy patients (psychological co-morbidity, quality of life and sleep interference measures).

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