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Douleur Neuropathique 4 (DN4)
Please visit this website for more information about the instrument: Douleur Neuropathique 4
Supplemental: Spinal Cord Injury (SCI)
Short Description of Instrument
The DN4 is a French tool developed to distinguish between neuropathic and non-neuropathic pain. Seven items are related to symptoms and three items are related to the clinical examination.

A score of 1 is given to each 'yes' item. The total score is the sum of the 10 items, and the cutoff value for the diagnosis of neuropathic pain is a total score of greater than 4 out of 10.

Comments/Special Instructions
The DN4 questionnaire can be used to screen and identify neuropathic pain (Calmels et al. 2009). DN4 has been found to have good sensitivity, specificity, and interrater reliability.
Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, LantÉri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1-2):29-36.
Calmels P, Mick G, Perrouin-Verbe B, Ventura M, SOFMER (French Society for Physical Medicine and Rehabilitation). Neuropathic pain in spinal cord injury: identification, classification, evaluation.
Ann Phys Rehabil Med. 2009;52(2):83-102.
HallstrÖm H, Norrbrink C. Screening tools for neuropathic pain: can they be of use in individuals with spinal cord injury? Pain. 2011;152(4):772-779.


Document last updated June 2020