The Prevalence of Neuropathic Pain in Multiple Sclerosis—A Systematic Review and Meta‐Analysis Using the NeuPSIG Algorithm

Classified as probably not a substantial claim. May combine two claims.

According to the NeuPSIG algorithm, possible neuropathic pain requires that the medical history prompts a possible explanation for neuropathic pain and patients present with clinical symptoms, and that the pain distribution is neuroanatomically plausible.

“To indicate possible neuropathic pain, patients must meet two criteria. First, the medical history should prompt a possible explanation for neuropathic pain, and patients should present with clinical symptoms. Second, the experienced pain distribution must be neuroanatomically plausible (i.e., the experienced pain is likely to correspond to the patient's neurological damage) (Finnerup et al. 2016;”

• cites Finnerup et al. 2016 sourceSupported
• cites Schmid et al. 2023 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The review was preregistered at PROSPERO (CRD42024603211) before initiation of screening.

“The review followed PRISMA guidelines and was preregistered at PROSPERO (CRD42024603211) before initiation of screening (Page et al. 2021).”

• cites Page et al. 2021 sourcePartly supported

  The “How to use PRISMA 2020” section identifies this paper as the PRISMA reporting guideline, supporting the guideline reference. It does not establish that the citing review followed PRISMA or that it registered PROSPERO record CRD42024603211 before screening; searches for the record and registration timing found no such passage. No page number was provided in our copy. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim.

According to the NeuPSIG algorithm, probable neuropathic pain additionally requires that pain is associated with sensory abnormalities in the same neuroanatomically plausible distribution.

“To indicate probable neuropathic pain, pain must also be associated with sensory abnormalities (i.e., clinical signs such as allodynia and/or hyperalgesia) in the same neuroanatomical plausible distribution (Finnerup et al. 2016; Schmid et al. 2023).”

• cites Finnerup et al. 2016 sourcePartly supported

  Section 4.2 says probable neuropathic pain generally requires examination evidence of sensory signs concordant with the suspected lesion or disease. But the Figure 2 caption says sensory changes may extend beyond, lie within, or overlap the pain area, and that probable neuropathic pain can sometimes be assigned without demonstrable sensory signs when a diagnostic test confirms the lesion or disease. Thus the claim's absolute requirement for abnormalities in the same distribution overstates the algorithm. Page numbers are not available in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Schmid et al. 2023 sourcePartly supported

  Section 4.2.2, Recommendation 2, says sensory signs in the same neuroanatomically plausible distribution support probable neuropathic pain. But section 4.2 also allows a classification of probable neuropathic pain without cutaneous sensory signs when a diagnostic test confirms a lesion, so the claim's 'must' is too absolute. The paper also says it could not recommend whether allodynia or hyperalgesia alone suffice in spine-related leg pain. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The prevalence of neuropathic pain in the general population ranges from 7% to 10%.

“where estimates range from 7% to 10% (Baskozos et al. 2023; van Hecke et al. 2014).”

• cites Baskozos et al. 2023 sourceSupported
• cites van Hecke et al. 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

The Neuropathic Pain Special Interest Group (NeuPSIG) has developed a grading system for the identification of neuropathic pain.

“the Neuropathic Pain Special Interest Group (NeuPSIG) has developed a grading system for the identification of neuropathic pain (Finnerup et al. 2016; Schmid et al. 2023)”

• cites Finnerup et al. 2016 sourceSupported
• cites Schmid et al. 2023 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The review followed PRISMA guidelines.

“The review followed PRISMA guidelines and was preregistered at PROSPERO (CRD42024603211) before initiation of screening (Page et al. 2021).”

• cites Page et al. 2021 sourceSupported

Classified as probably not a substantial claim.

According to the NeuPSIG algorithm, definite neuropathic pain additionally requires objective confirmation of a lesion or disease in the somatosensory nervous system that may explain the pain.

“Lastly, to establish definite neuropathic pain, additional objective confirmation of a lesion or disease in the somatosensory nervous system that may explain the pain is required (Finnerup et al. 2016; Schmid et al. 2023).”

• cites Finnerup et al. 2016 sourceSupported
• cites Schmid et al. 2023 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The algorithms used across diagnostic certainty levels do not yield a definitive diagnosis of neuropathic pain; instead, the grading system evaluates the probability that experienced pain is caused by neurological damage, with increasing certainty as more criteria are met.

“Importantly, the algorithms used across diagnostic certainty levels do not yield a definitive diagnosis of neuropathic pain (i.e., not to be confused with definite neuropathic pain). Instead, the grading system evaluate the probability that the experienced pain is caused by neurological damage, with increasing certainty as more criteria are met (Finnerup et al. 2016).”

• cites Finnerup et al. 2016 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In multiple sclerosis, the McDonald criteria are the standard criteria for disease diagnosis; according to these criteria, patients must present with multiple lesions in the central nervous system that are disseminated in space.

“In MS, the McDonald criteria are the standard criteria for disease diagnosis. According to these criteria, patients must present with multiple lesions in the central nervous system (CNS) that are disseminated in space (Montalban et al. 2025).”

• cites Montalban et al. 2025 sourcePartly supported

  The indexed title identifies the McDonald criteria as criteria for diagnosing multiple sclerosis. However, the available passages contain only title and citation metadata; they do not establish that the criteria are the standard or that patients must have multiple CNS lesions disseminated in space. Searches for dissemination in space and lesion locations found no passage stating those requirements. (LLM, conf=0.70)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Achieving definite diagnostic certainty does not constitute absolute proof of central neuropathic pain but should be interpreted as a strong indication within the context of best clinical practice.

“Hence, achieving definite diagnostic certainty does not constitute absolute proof of central neuropathic pain but should rather be interpreted as a strong indication within the context of best clinical practice (Finnerup et al. 2016).”

• cites Finnerup et al. 2016 sourceSupported

May combine two claims.

The majority of studies meeting only possible criteria is likely because questionnaires such as DN4, PainDETECT, and LANSS are relatively easy to administer, whereas economic and professional constraints of physical and sensory examinations and objective confirmatory tests present major barriers to routine diagnostics.

“This is likely because questionnaires such as DN4, PainDETECT, and LANSS are relatively easy to administer. In contrast, the economic and professional constraints of physical and sensory examinations, as well as objective confirmatory tests (e.g., MRI or neurophysiological techniques), present major barriers to the routine implementation of such diagnostics (Truini et al. 2023).”

• cites Truini et al. 2023 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

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Sensitivity analysis removing lower clinical extremes for low disability, duration, and progression did not affect the conclusions, yielding 20.5% (95% CI 15.4-25.6), indicating no clear impact.

“After removing lower clinical extremes (Aliş et al. 2025; Ismail et al. 2025; Jallouli, Ghroubi, Ben Dhia, et al. 2025), the overall sensitivity analysis for low disability, duration, and progression similarly did not affect the conclusions (20.5% [95% CI: 15.4; 25.6]), indicating no clear impact.”

• cites Aliş et al. 2025 sourceNot checked — no full text of the source
• cites Ismail et al. 2025 sourceSupported
• cites Jallouli, Ghroubi, Ben Dhia, et al. 2025 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

In Parkinson's disease, when neuropathic pain is clinically present but a lesion to the somatosensory system cannot be confirmed by objective assessments, the diagnosis is considered probable.

“In Parkinson's disease, it has recently been suggested that when neuropathic pain is clinically present, but a lesion to the somatosensory system cannot be confirmed by objective assessments, the diagnosis is to be considered probable (Tinazzi et al. 2025).”

• cites Tinazzi et al. 2025 sourceCould not verify

  The available passages contain bibliographic details (the passage labeled Abstract, page not given), but no discussion of neuropathic-pain diagnostic criteria. Searches for probable neuropathic pain, somatosensory lesions, and objective assessments found no passage addressing the claim. (LLM, conf=0.75)

  Experimental — accuracy not yet measured

May combine two claims.

Increased lesion load is correlated with disease duration, Expanded Disability Status Scale, and multiple sclerosis phenotypes, and is therefore expectedly positively associated with increased prevalence of neuropathic pain.

“It has been shown that increased lesion load is correlated with disease duration, Expanded Disability Status Scale (EDSS) and MS phenotypes, and is therefore expectedly (positively) associated with increased prevalence of neuropathic pain (Ismail et al. 2025; Solaro et al. 2018; Srotova et al. 2021; Svendsen et al. 2011).”

• cites Ismail et al. 2025 sourcePartly supported

  The Results and Table 7 (page not available in our copy) report a positive correlation between MRI lesion count and pain severity. The Introduction also links neuropathic-pain risk to longer disease duration and greater disability, but the paper does not establish that lesion load correlates with duration, EDSS, or MS phenotypes, or directly report a lesion-load correlation with pain prevalence. Its study included only relapsing-remitting MS patients. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Solaro et al. 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Srotova et al. 2021Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim. May combine two claims.

Given these considerations and existing guidelines, establishing a probable diagnosis of neuropathic pain may be adequate for prompting analgesic treatments in people with multiple sclerosis, provided the patient has a valid diagnosis of multiple sclerosis.

“Given these considerations and in line with existing guidelines, the establishment of a probable diagnosis of neuropathic pain may be adequate for prompting analgesic treatments in pwMS, provided that the patient has a valid diagnosis of MS (Finnerup et al. 2016; Treede et al. 2019).”

• cites Finnerup et al. 2016 sourceSupported
• cites Treede et al. 2019 sourcePartly supported

  Section 3.2.3 describes grading the certainty of neuropathic-pain diagnoses and distinguishes definite diagnosis from less certain diagnoses. Section 3.2 says identifying chronic pain can facilitate treatment pathways. Neither passage says that a probable diagnosis is sufficient to prompt analgesic treatment in people with multiple sclerosis, or that a valid MS diagnosis is the condition for doing so. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

Sensitivity analysis removing individual outliers did not affect the overall conclusions for overall or possible neuropathic pain, yielding 18.8% (95% CI 15.0-22.7) and 17.6% (95% CI 13.2-22.0), indicating robustness of the results.

“The sensitivity analysis did not affect the overall conclusions of estimated prevalences after removing individual outliers (Feketová et al. 2017; Jallouli, Ghroubi, Ben Dhia, et al. 2025; Moisset et al. 2013), for either overall (18.8% [95% CI: 15.0; 22.7]) or possible (17.6% [95% CI: 13.2; 22.0]) neuropathic pain, indicating robustness of the results.”

• cites Feketová et al. 2017 sourceCould not verify

  The Patients and Methods section (p. 2) describes analyses of this paper’s patient data, while the Prevalence of central pain section (p. 5) discusses its prevalence estimates. Searches for sensitivity analysis, removal of outliers, and the quoted prevalence estimates found no passage addressing whether removing this study changed the citing paper’s pooled results. (LLM, conf=0.76)

  Experimental — accuracy not yet measured
• cites Jallouli, Ghroubi, Ben Dhia, et al. 2025 sourceNot checked — no full text of the source
• cites Moisset et al. 2013 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

A possible diagnosis cannot replace the probable and definite certainty provided by NeuPSIG in clinical practice.

“Importantly, a possible diagnosis cannot replace the probable and definite certainty provided by NeuPSIG in clinical practice (Finnerup et al. 2016).”

• cites Finnerup et al. 2016 sourceSupported

May combine two claims.

A recent study found that the majority of people with multiple sclerosis experience co-occurring pains, often encompassing multiple phenotypes at once.

“A recent study supports this argument by finding that the majority of pwMS experience co‐occurring pains, often encompassing multiple phenotypes at once (Dagnew et al. 2025).”

• cites Dagnew et al. 2025 sourceSupported

May combine two claims.

Studies exclusively investigating people with multiple sclerosis and pain cannot accurately estimate the true prevalence of neuropathic pain, so the current review excluded such studies.

“The current review excluded such studies, as these cannot accurately estimate the true prevalence of neuropathic pain (Truini et al. 2023).”

• cites Truini et al. 2023 sourceCould not verify

  The Screening Questionnaires section says that recruitment at pain centres may explain why some studies found a higher prevalence of neuropathic pain than epidemiological studies. It does not address whether studies restricted to people with multiple sclerosis and pain can estimate neuropathic-pain prevalence. Searches for multiple sclerosis and pain-only study populations found no passage establishing the cited rationale. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

The prevalence of neuropathic pain in people with multiple sclerosis (22.3%) is substantially higher than the 7%-10% observed in the general population.

“The main findings support this assumption by presenting an overall prevalence of neuropathic pain of 22.3% (95% CI: 17.3; 27.3) in pwMS, which is substantially higher than the 7%–10% observed in the general population (Baskozos et al. 2023; van Hecke et al. 2014).”

• cites Baskozos et al. 2023 sourceSupported
• cites van Hecke et al. 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Pain in multiple sclerosis is rarely exclusively neuropathic and often presents as a co-occurrence of nociceptive and neuropathic pain characteristics, further complicating diagnoses.

“Furthermore, pain in MS is rarely exclusively neuropathic and often presents as a co‐occurrence of nociceptive and neuropathic pain characteristics, further complicating diagnoses (Tinazzi et al. 2025).”

• cites Tinazzi et al. 2025 sourceCould not verify

  The available passages contain bibliographic information identifying this as a review of pain in Parkinson’s disease, but no passage addresses pain in multiple sclerosis. Searches for MS pain and for the claimed co-occurrence of neuropathic and nociceptive characteristics returned no relevant passage, so our copy cannot verify the claim. (LLM, conf=0.75)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

In line with NeuPSIG guidelines, a possible diagnosis appears appropriate for epidemiologic purposes and for initial examinations, prompting clinicians to conduct further neurological examinations in people with multiple sclerosis.

“In line with NeuPSIG guidelines, a possible diagnosis appears appropriate for epidemiologic purposes and for initial examinations, prompting clinicians to conduct further neurological examinations in pwMS (Truini et al. 2023).”

• Also stated in: § Conclusion · hedged

  “As such, in line with international recommendations, possible diagnostic certainty appears appropriate for epidemiological purposes as well as for initial screening of pain phenotype in pwMS.”

• cites Truini et al. 2023 sourcePartly supported

  The Discussion (page unavailable) says screening questionnaires are useful in epidemiological studies and can help identify ‘possible’ neuropathic pain at the first stage of the NeuPSIG algorithm. The Introduction (page unavailable) describes sensory signs and objective tests as requirements for higher diagnostic certainty. The guidelines do not specifically recommend this approach or further neurological examinations for people with multiple sclerosis; that is the citing authors’ application of the general guidance. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The literature search yielded 1638 records.

“The literature search yielded 1638 records, of which 32 papers were considered eligible for inclusion.”

May combine two claims.

Thirty-two papers were considered eligible for inclusion and were included in the review and meta-analysis.

“The literature search yielded 1638 records, of which 32 papers were considered eligible for inclusion.”

• Also stated in: § Results · plain

  “N = 32 individual papers were identified and included in data extraction and subsequently incorporated into the meta‐analysis.”

May combine two claims.

Across all included studies, the majority only met the criteria for possible neuropathic pain, while only a few studies complied with probable or definite neuropathic pain.

“Across all the included studies, the majority only met the criteria for possible neuropathic pain, while only a few studies complied with probable or definite neuropathic pain.”

May combine two claims.

The estimated prevalence of definite neuropathic pain was 23.4% (95% CI 11.1-35.8), with a heterogeneity of 92.1%.

“Lastly, the estimated prevalence of definite neuropathic pain was 23.4%, 95% CI (11.1; 35.8), with a heterogeneity of 92.1% (Figure 5).”

May combine two claims.

The estimated prevalence of possible neuropathic pain in people with multiple sclerosis was 22.0% (95% CI 16.0-28.0), with a heterogeneity of 97.4%.

“Stratified by diagnostic certainty, the estimated prevalence of possible neuropathic pain in pwMS was 22.0%, 95% CI (16.0; 28.0), with a heterogeneity of 97.4% (Figure 3).”

May combine two claims.

The overall pooled prevalence of neuropathic pain in people with multiple sclerosis was 22.3% (95% CI 17.3-27.3), with a heterogeneity of 97.1%.

“Overall pooled estimates of neuropathic pain in pwMS revealed a prevalence of 22.3%, 95% CI (17.3; 27.3), with a heterogeneity of 97.1% (Figure 2).”

• Also stated in: § Conclusion · plain

  “The findings of the current review revealed an overall prevalence of 22.3% (95% CI: 17.3; 27.3) for neuropathic pain in pwMS.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The quality assessment was conducted by two independent reviewers across all included studies, with consensus through discussion for conflicts.

“The quality assessment was conducted by two independent reviewers (R.C.J. and V.K.B.) across all included studies. In the event of any conflicting assessments, a consensus was reached through discussion.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

One reviewer extracted all data, with another reviewer verifying the findings.

“One reviewer (R.C.J.) extracted all data, with another (V.K.B.) verifying the findings.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The same approach was applied to assess the impact of EDSS, disease duration and disease progression in a clinical sensitivity analysis.

“The same approach was applied to assess the impact of EDSS, disease duration and disease progression in a clinical sensitivity analysis.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The Joanna Briggs Institute's critical appraisal tool for analytical cross-sectional studies was added because of its tailored design for cross-sectional studies, which was not otherwise covered by the Newcastle-Ottawa Scale.

“Regarding risk of bias analysis, the Joanna Briggs Institute's critical appraisal tool for analytical cross‐sectional studies was added. This was done because of the tailored design for cross‐sectional studies, which was not otherwise covered by the Newcastle–Ottawa Scale (Ma et al. 2020).”

• cites Ma et al. 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Two independent reviewers conducted title-and-abstract screening, blinded to each other's decisions, and reached collective agreement.

“First, two independent reviewers (R.C.J. and V.K.B.) conducted a title‐and‐abstract screening using http://covidence.org/ (2025). Both were blinded to each other's decisions, and a collective agreement was ultimately reached.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The analysis adhered to the Meta-analysis of Observational Studies in Epidemiology framework.

“The analysis adhered to the Meta‐analysis of Observational Studies in Epidemiology framework and was conducted using the Generic Inverse Variance method with a random‐effects model due to the substantial heterogeneity between the results of included studies (Stroup et al. 2000).”

• cites Stroup et al. 2000Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Cross-sectional studies were evaluated using the Joanna Briggs Institute's critical appraisal tool for analytical cross-sectional studies.

“Cross‐sectional studies were evaluated using the Joanna Briggs Institute's (JBI) critical appraisal tool for analytical cross‐sectional studies.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Case-control and cohort studies were assessed using the Newcastle-Ottawa Scale.

“Case–control and cohort studies were assessed using the Newcastle–Ottawa Scale (NOS).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The prevalence of neuropathic pain in people with MS has been estimated at around 27%.

“The prevalence of neuropathic pain in pwMS has been estimated at around 27% (Rodrigues et al. 2023)”

• cites Rodrigues et al. 2023 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Distinguishing between neuropathic and non-neuropathic pain remains challenging, and with the change in definition, there has been an increased demand for greater scrutiny in the diagnosis.

“Distinguishing between neuropathic and non‐neuropathic pain remains challenging, and with the change in definition, there has been an increased demand for greater scrutiny in the diagnosis (Hoegh and Hodges 2025).”

• cites Hoegh and Hodges 2025 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

A sensitivity analysis was conducted to assess the robustness of the findings.

“A sensitivity analysis was conducted to assess the robustness of the findings; substantial changes in the estimated prevalences after removing individual outliers were considered significant if they affected the overall conclusions.”

May combine two claims.

Based on this review's findings, self-reported questionnaires appear appropriate for initial screening and epidemiological purposes, as pooled prevalences yielded estimates numerically similar to those at the probable and definite certainty levels.

“However, based on the findings of this review, these questionnaires appear appropriate for initial screening and epidemiological purposes, as pooled prevalences yielded estimates numerically similar to those at the probable and definite certainty levels.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Accurately identifying pain descriptors in accordance with best practice increases confidence in the underlying mechanism and, in turn, the likelihood of a successful treatment outcome.

“Accurately identifying pain descriptors in accordance with best practice is thus essential, as it increases confidence in the underlying mechanism and, in turn, the likelihood of a successful treatment outcome.”

May combine two claims.

Substantial differences in the number of studies included across the three diagnostic certainty strata and heterogeneous methodology across studies may have influenced the overall estimates, making the findings subject to cautious interpretation, especially probable neuropathic pain, as this prevalence is based solely on one study.

“Furthermore, the substantial differences in the number of studies included across the three diagnostic certainty strata as well as the heterogeneous methodology across studies may have influenced the overall estimates, making the findings subject to cautious interpretation, especially in regard to probable neuropathic pain, as this prevalence is based solely on one study (Ferraro et al. 2018).”

• cites Ferraro et al. 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Using predominantly self-reported questionnaires when screening for neuropathic pain may increase the risk of misdiagnosis.

“A previous study indicates that using predominantly self‐reported questionnaires when screening for neuropathic pain may increase the risk of misdiagnosis (Vaegter et al. 2014).”

• cites Vaegter et al. 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The higher prevalence estimates observed for definite and probable neuropathic pain than for possible neuropathic pain appear counterintuitive and likely reflect substantial methodological heterogeneity among studies rather than true variation across diagnostic certainty levels.

“The higher prevalence estimates observed for definite and probable neuropathic pain thus appear counterintuitive. This likely reflects substantial methodological heterogeneity among studies (Table 2), rather than true variation across diagnostic certainty levels.”

• AssumptionRests on an assumption: Possible diagnostic certainty should encompass cases of definite neuropathic pain.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Descriptor-based approaches have been proposed as tools for optimal prescription of analgesic treatments, as treatments for neuropathic pain differ from those for other pain phenotypes.

“While further research is still needed, descriptor‐based approaches have been proposed as tools for optimal prescription of analgesic treatments, as treatments for neuropathic pain differ from those for other pain phenotypes (Hoegh and Hodges 2025).”

• cites Hoegh and Hodges 2025 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The spinothalamic tract has been linked to neuropathic pain, consistent with its well-established role in the somatosensory nervous system.

“This seems especially true for the spinothalamic tract (i.e., the neural pain pathway), which has been linked to neuropathic pain (Truini et al. 2013), consistent with its well‐established role in the somatosensory nervous system.”

• cites Truini et al. 2013Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

The review's findings should not be interpreted as direct comparisons between diagnostic certainty levels but rather as individual prevalence estimates.

“As such, our findings should not be interpreted as direct comparisons between diagnostic certainty but rather as individual prevalence estimates.”

May combine two claims.

The estimate of probable neuropathic pain is based on a single study, precluding direct comparisons across diagnostic certainty levels.

“Furthermore, the estimate of probable neuropathic pain is based on a single study, precluding direct comparisons across diagnostic certainty levels.”

May combine two claims.

Only one eligible study met the criteria for probable neuropathic pain, so a meta-analysis could not be performed due to the lack of multiple independent data points.

“Only one eligible study was found complying with the criteria for probable neuropathic pain. Consequently, a meta‐analysis could not be performed due to the lack of multiple independent data points.”

May combine two claims.

Most of the pain experienced by people with multiple sclerosis will likely present as either co-occurring pains (most likely) or strictly as neuropathic pain (less likely).

“Therefore, most of the pain experienced by pwMS will likely present as either co‐occurring pains (most likely) or strictly as neuropathic pain (less likely).”

May combine two claims.

A previous review reported an overall prevalence of neuropathic pain in people with multiple sclerosis of 26.8%, which differs from the current review's 22.3%.

“A previous review aimed to estimate the overall prevalence of neuropathic pain in pwMS (Rodrigues et al. 2023). However, its result (26.8%) differs from that of the current review (22.3%).”

• cites Rodrigues et al. 2023 sourceNot checked — no full text of the source

May combine two claims.

All people with multiple sclerosis will already have objective evidence of central nervous system lesions, possibly explaining their experienced pain.

“All pwMS will thus already have objective evidence of CNS lesions, possibly explaining their experienced pain.”

Classified as probably not a substantial claim.

A key strength of the current study is its strict methodological approach, with clear discrimination among diagnostic certainty levels.

“First, a key strength of the current study, which may further explain discrepancies from previous findings, is its strict methodological approach (i.e., clear discrimination among diagnostic certainty levels).”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The advantage of a grading system for neuropathic pain is that it allows many factors, such as prior experience and patient preferences, to be incorporated into the final judgement.

“The advantage of a grading system for neuropathic pain is that it allows many factors, such as prior experience and patient preferences, to be incorporated into the final judgement.”

Classified as probably not a substantial claim. May combine two claims.

The current review focused on overall neuropathic pain and therefore excluded studies reporting exclusively on specific neuropathic pain subtypes or co-occurring pain when presented.

“Additionally, the current review focused on overall neuropathic pain, and therefore excluded studies reporting exclusively on specific neuropathic pain subtypes (e.g., trigeminal neuralgia or Lhermitte's phenomenon) or co‐occurring pain when presented.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Distinguishing between individual subtypes upon diagnosing the underlying pain phenotype remains highly important for prevalence estimates.

“However, it is acknowledged that distinguishing between individual subtypes upon diagnosing the underlying pain phenotype remains highly important for prevalence estimates (Foley et al. 2013).”

• cites Foley et al. 2013Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.