ORIGINAL ARTICLE Validation of the Greek Version of the DN4 Diagnostic Questionnaire for Neuropathic Pain Panagiota Sykioti, MD, MRCPsych*; Panagiotis Zis, MD, MRCPsych, MSc, PhD † ; Athina Vadalouca, MD, PhD, FIPP*; Ioanna Siafaka, MD, PhD*; Eriphili Argyra, MD, PhD*; Didier Bouhassira, MD, PhD ‡ ; Evmorfia Stavropoulou, MD*; Nikolaos Karandreas, MD, PhD § *1st Anaesthesiology Clinic, Pain Relief and Palliative Care Unit, Aretaieion University Hospital, University of Athens, Athens; † Department of Neurology, Evangelismos General Hospital, Athens, Greece; ‡ Inserm U987, Ambroise Pare Hospital, Boulogne-Billancourt and UVSQ University, Versailles, France; § 1st Department of Neurology, Aeginition Hospital, University of Athens, Athens, Greece & Abstract Background: The Douleur Neuropathique 4 questionnaire (DN4) was developed by the French Neuropathic Pain Group and is a simple and objective tool, primarily designed to screen for neuropathic pain. The aim of our study is to validate the DN4 in the Greek language. Methods: The study was set up as a prospective observa- tional study. Two pain specialists independently examined patients and diagnosed them with neuropathic, nociceptive, or mixed pain, according to the International Association for the Study of Pain (IASP) definitions. A third and a fourth physician administered the DN4 questionnaire to the patients. Results: Out of the 237 patients who met our inclusion criteria and had identical diagnoses regarding the type of pain, 123 were diagnosed with neuropathic, 59 with noci- ceptive, and 55 with mixed pain. Among patients with identical diagnoses of neuropathic or nociceptive pain, using a receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) was 0.92. A cutoff point of equal or greater than 4 resulted in a sensitivity of 93% and a specificity of 78%. Among patients suffering from pain with neuropathic element (neuropathic or mixed pain) or pain with no neuropathic element (nociceptive pain), using a ROC curve analysis, the AUC was 0.89. A cutoff point of equal or greater than 4 resulted in a sensitivity of 89% and a specificity of 78%. Conclusion: The Greek version of DN4 is a valid tool for discriminating between neuropathic and nociceptive pain conditions in daily practice. & Key Words: pain, neuropathic, DN4, Douleur Neuropathi- que 4, validation, Greek INTRODUCTION We can ignore even pleasure, but pain insists upon being attended to. God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is his megaphone to rouse a deaf world. 1 Pain is a universal experience and the human body’s most valuable alerting system. According to Interna- tional Association for the Study of Pain (IASP), pain is defined as an unpleasant sensory and emotional Address correspondence and reprint requests to: Panagiotis Zis, MD, MRCPsych, MSc, PhD, Department of Neurology, Evangelismos General Hospital, 45-47 Ipsilantou Str, 10676, Athens, Greece. E-mail: takiszis@gmail.com. Submitted: November 11, 2013; Revision accepted: March 19, 2014 DOI. 10.1111/papr.12221 © 2014 World Institute of Pain, 1530-7085/14/$15.00 Pain Practice, Volume , Issue , 2014 –