The Prevalence of Neuropathic Pain in Multiple Sclerosis-A Systematic Review and Meta-Analysis Using the NeuPSIG Algorithm
Abstract
Background and objectives: Multiple sclerosis (MS) is a neurodegenerative disorder frequently leading to neuropathic pain. Due to the neurodegenerative nature, the diagnosis of neuropathic pain remains challenging. A grading system has been developed providing an overview of diagnostic certainty (i.e., possible, probable and definite). Since no previous review has accounted for this, differences in diagnostic certainty may have affected prevalence estimates. To elucidate this issue, the current meta-analysis aimed to estimate the prevalence of possible, probable and definite neuropathic pain separately, as well as the overall prevalence of neuropathic pain in MS.
Databases and data treatment: A comprehensive systematic literature review was conducted (by 14-10-2025) using PubMed, Embase and Scopus databases, adhering to the PRISMA guidelines. For the meta-analysis, we applied the Generic Inverse Variance method, using a random-effects model for proportions to compute prevalence estimates for possible, probable and definite neuropathic pain, as well as for overall prevalence.
Results: The literature search yielded 1638 records, of which 32 papers were considered eligible for inclusion. Disregarding diagnostic certainty, the overall prevalence of neuropathic pain in people with MS was estimated at 22.3% (95% CI: 17.3; 27.3). Following stratification by diagnostic certainty, the prevalence of possible neuropathic pain was 22.0% (95% CI: 16.0; 28.0), probable neuropathic pain…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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