Journal ArticleDOI
Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus.
Miroslav Backonja,Nadine Attal,Ralf Baron,Didier Bouhassira,Mark Drangholt,Peter J. Dyck,Robert R. Edwards,Roy Freeman,Richard H. Gracely,Maija H. Haanpaa,Per Hansson,Samar Hatem,Elena K. Krumova,Troels S. Jensen,Christoph Maier,Gérard Mick,Andrew S.C. Rice,Roman Rolke,Rolf-Detlef Treede,Jordi Serra,Thomas R Toelle,Valeri Tugnoli,David Walk,Mark S. Walalce,Mark A. Ware,David Yarnitsky,Dan Ziegler +26 more
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TLDR
Quantitative sensory testing (QST) is a psychophysical method used to quantify somatosensory function in response to controlled stimuli in healthy subjects and patients as discussed by the authors, which has not gained a large acceptance among clinicians for many reasons, and in significant part because of the lack of information about standards for performing QST, its potential utility and interpretation of results.Abstract:
Quantitative sensory testing (QST) is a psychophysical method used to quantify somatosensory function in response to controlled stimuli in healthy subjects and patients. Although QST shares similarities with the quantitative assessment of hearing or vision, which is extensively used in clinical practice and research, it has not gained a large acceptance among clinicians for many reasons, and in significant part because of the lack of information about standards for performing QST, its potential utility, and interpretation of results. A consensus meeting was convened by the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG) to formulate recommendations for conducting QST in clinical practice and research. Research studies have confirmed the utility of QST for the assessment and monitoring of somatosensory deficits, particularly in diabetic and small fiber neuropathies; the assessment of evoked pains (mechanical and thermal allodynia or hyperalgesia); and the diagnosis of sensory neuropathies. Promising applications include the assessment of evoked pains in large-scale clinical trials and the study of conditioned pain modulation. In clinical practice, we recommend the use QST for screening for small and large fiber neuropathies; monitoring of somatosensory deficits; and monitoring of evoked pains, allodynia, and hyperalgesia. QST is not recommended as a stand-alone test for the diagnosis of neuropathic pain. For the conduct of QST in healthy subjects and in patients, we recommend use of predefined standardized stimuli and instructions, validated algorithms of testing, and reference values corrected for anatomical site, age, and gender. Interpretation of results should always take into account the clinical context, and patients with language and cognitive difficulties, anxiety, or litigation should not be considered eligible for QST. When appropriate standards, as discussed here, are applied, QST can provide important and unique information about the functional status of somatosensory system, which would be complementary to already existing clinical methods.read more
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Journal ArticleDOI
Early Detection of Diabetic Peripheral Neuropathy: A Focus on Small Nerve Fibres
Jamie Burgess,Bernhard Frank,Andrew Marshall,Rashaad S Khalil,Georgios Ponirakis,Ioannis N. Petropoulos,Daniel J. Cuthbertson,Rayaz A. Malik,Rayaz A. Malik,Uazman Alam,Uazman Alam +10 more
TL;DR: In this paper, Corneal confocal microscopy (CCM) is used to quantify small nerve fibre damage and repair which can be conducted alongside retinopathy screening to identify early subclinical DPN, predicts the development and allows staging of DPN severity.
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Chronic neuropathic pain in SCI: evaluation and treatment.
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Journal ArticleDOI
Somatosensory profiles in acute herpes zoster and predictors of postherpetic neuralgia.
Sybille Kramer,Petra I. Baeumler,Christian Geber,Johannes Fleckenstein,Michael Simang,Laura Haas,Gabriel Schober,Florian Pfab,Rolf-Detlef Treede,Dominik Irnich +9 more
TL;DR: Sensory signs at distant body sites, strong affective pain perception, as well as reduced quality of life and physical functioning in the acute phase may reflect risk factors for the transition to postherpetic neuralgia (PHN).
Journal ArticleDOI
Assessment of Somatosensory Function in Patients With Idiopathic Dry Eye Symptoms
Anat Galor,Roy C. Levitt,Katherine T. McManus,Jerry P. Kalangara,Benjamin E. Seiden,Jasmine J. Park,Derek Covington,Constantine D. Sarantopoulos,Elizabeth R. Felix +8 more
TL;DR: It is demonstrated that neuropathic-like DE pain symptom severity correlates with quantitative measures of pain sensitivity at a site remote from the eye.
Journal ArticleDOI
Development, Validation, and Field-Testing of an Instrument for Clinical Assessment of HIV-Associated Neuropathy and Neuropathic Pain in Resource-Restricted and Large Population Study Settings
Yohannes W. Woldeamanuel,Yohannes W. Woldeamanuel,Peter R. Kamerman,Demetri G. A. Veliotes,Tudor Phillips,Tudor Phillips,David Asboe,Marta Boffito,Andrew S.C. Rice +8 more
TL;DR: A combination of four easily and quickly assessed clinical items can be used to accurately diagnose HIV-SN and DN4-interview used in the context of bilateral feet pain can beused to identify those with neuropathic pain.
References
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Journal ArticleDOI
Neuropathic pain Redefinition and a grading system for clinical and research purposes
Rolf-Detlef Treede,Troels S. Jensen,James N. Campbell,Giorgio Cruccu,Jonathan O. Dostrovsky,J. W. Griffin,Per Hansson,Richard A. C. Hughes,Turo Nurmikko,Jordi Serra +9 more
TL;DR: A grading system of definite, probable, and possible neuropathic pain is proposed, which includes the grade possible, which can only be regarded as a working hypothesis, and the grades probable and definite, which require confirmatory evidence from a neurologic examination.
Journal ArticleDOI
Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values
Roman Rolke,Ralf Baron,Christoph Maier,Thomas R. Tölle,Rolf-Detlef Treede,Antje Beyer,Andreas Binder,Niels Birbaumer,Frank Birklein,I. C. Bötefür,S. Braune,Herta Flor,Volker Huge,R. Klug,G. B. Landwehrmeyer,Walter Magerl,Christian Maihöfner,C. Rolko,C. Schaub,Andrea Scherens,Till Sprenger,Michael Valet,B. Wasserka +22 more
TL;DR: Application of this standardized QST protocol in patients and human surrogate models will allow to infer underlying mechanisms from somatosensory phenotypes as well as judge plus or minus signs in patients.
Journal ArticleDOI
Quantitative sensory testing: a comprehensive protocol for clinical trials
Roman Rolke,Walter Magerl,K. Andrews Campbell,C. Schalber,S. Caspari,Frank Birklein,Rolf-Detlef Treede +6 more
TL;DR: A comprehensive QST protocol is compiled using well established tests for nearly all aspects of somatosensation to test for patterns of sensory loss or gain, and to assess both cutaneous and deep pain sensitivity.
Journal ArticleDOI
An association between migraine and cutaneous allodynia
Rami Burstein,Rami Burstein,David Yarnitsky,Itay Goor-Aryeh,Bernard J. Ransil,Zahid H. Bajwa +5 more
TL;DR: These findings suggest that the pathophysiology of migraine involves not only irritation of meningeal perivascular pain fibers but also a transient increase in the responsiveness of central pain neurons that process information arising from intracranial structures and skin.
Journal ArticleDOI
NeuPSIG guidelines on neuropathic pain assessment
Maija Haanpää,Nadine Attal,Miroslav Backonja,Ralf Baron,Michael I. Bennett,Didier Bouhassira,Giorgio Cruccu,Per Hansson,Jennifer A. Haythornthwaite,Gian Domenico Iannetti,Troels S. Jensen,Timo Kauppila,Turo Nurmikko,Andew S C Rice,Michael C. Rowbotham,Jordi Serra,Claudia Sommer,Blair H. Smith,Rolf-Detlef Treede +18 more
TL;DR: Screening questionnaires are suitable for identifying potential patients with neuropathic pain, but further validation of them is needed for epidemiological purposes and quantitative sensory testing is recommended for selected cases in clinic, including the diagnosis of small fiber neuropathies and for research purposes.
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