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
Associations between pain thresholds for heat, cold and pressure, and Pain Sensitivity Questionnaire scores in healthy women and in women with persistent pelvic pain.
TL;DR: The aims of the study were to assess the associations between PSQ scores and QST in women with persistent pelvic pain and in pain‐free controls and to what extent demographic variables and psychological distress influencedPSQ scores.
Journal ArticleDOI
Contralateral Sensory and Pain Perception Changes in Patients With Unilateral Neuropathy.
Elena K. Enax-Krumova,Nadine Attal,Didier Bouhassira,Rainer Freynhagen,Janne Gierthmühlen,Per Hansson,Per Hansson,Bianca M. Kuehler,Bianca M. Kuehler,Christoph Maier,Juliane Sachau,Märta Segerdahl,Thomas R. Tölle,Rolf-Detlef Treede,Lise Ventzel,Ralf Baron,Jan Vollert,Jan Vollert +17 more
TL;DR: In this article, the authors analyzed the contralateral clinically unaffected side of patients with unilateral painful or painless neuropathy (peripheral nerve injury [PNI], postherpetic neuropathy [PHN], radiculopathy) by standardized quantitative sensory testing following a validated protocol.
Journal ArticleDOI
NerveCheck for the Detection of Sensory Loss and Neuropathic Pain in Diabetes
Georgios Ponirakis,Maria N Odriozola,Samantha Odriozola,Ioannis N. Petropoulos,Shazli Azmi,Maryam Ferdousi,Hassan Fadavi,Uazman Alam,Andrew Marshall,Maria Jeziorska,Anthony Miro,Ahmad Kheyami,Mitra Tavakoli,Ahmed Al-Ahmar,Maria B Odriozola,Ariel Odriozola,Rayaz A. Malik +16 more
TL;DR: NerveCheck is a low-cost QST device with good diagnostic utility for identifying sensory deficits, comparable to established tests of large and small fiber neuropathy and for the severity of neuropathic pain.
Journal ArticleDOI
Validation of diagnostic methods for traumatic sensory neuropathy and neuropathic pain.
TL;DR: Neurography or combinations of neurophysiologic and quantitative tests enables most reliable early and late diagnosis of iatrogenic sensory neuropathy and the single most accurate test was sensory neurography.
Journal ArticleDOI
Small fiber neuropathy as a possible cause for chronic pruritus
TL;DR: Early identification of small fiber neuropathy and immediate treatment of the cause is crucial for the success of the treatment and symptomatic approach to this condition should be taken into account.
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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