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Importantly, it should be highlighted that when CD38 is catalyzing the degradation of NAD to ADPR, or the cyclization of NAD to cADPR, there is NAD consumption and nicotinamide generation, leading to the crucial role of CD38 in tissue NAD and nicotinamide homeostasis [6, 34-35, 38-40]

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The American Academy of Neurology (AAN) has a well-published guideline for treatment that includes gabapentinoids, anticonvulsants and antidepressants.6 Despite the availability of multiple pharmacologic therapies, many patients continue to have uncontrolled pain or cannot tolerate side effects