Central Nervous System Involvement in Painful Diabetic Neuropathy

People with diabetes are at increased risk of developing painful diabetic neuropathy. Current guidelines that are aimed at symptom control achieved meaningful pain relief in only a third of patients. Intractable painful neuropathy often results in significant comorbidity, suffering and loss of productivity. Novel approaches to investigate the pathogenesis and more accurately phenotype patients with neuropathic pain may result in better treatment outcomes. Over the past two decades research on central nervous system involvement in diabetic neuropathy has identified novel biomarkers of pain phenotypes and treatment response. These markers shed light on the mechanisms of neuropathic pain in diabetes and have clear implications for future research and increasingly in pain phenotyping and might ultimately guide targeted treatment.