Quantitative sensory tests in patients with neuralgia 11 to 25 years after injury

Opioids, the frontline drugs for postsurgical analgesia, have been linked to diversion and abuse with lethal consequences. The search for safe analgesics with less harm potential has been decades long. However, clinical trials for safe opioid and nonopioid analgesics have relied on subjective pain reports, which are biased by placebo effects that increase the complexity of trials to develop new therapies to manage pain.Research in opioid naïve animals and humans demonstrates that blood concentrations of opioids that effectively saturate the morphine opioid receptor are tightly linked with patient reports and quantitative sensory tests for analgesia. Opioid drug concentrations can predict clinical responses.This report reviews preclinical and clinical evidence correlating buprenorphine pharmacokinetics with analgesia. More than 30 years of data confirm buprenorphine blood concentrations can be an objective biomarker of analgesia for moderate to severe acute postoperative pain.

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Repeatability of quantitative sensory testing in healthy cats in a clinical setting with comparison to cats with osteoarthritis

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x17690653 ◽

2017 ◽

Vol 19 (12) ◽

pp. 1274-1282 ◽

Cited By ~ 12

Author(s):

Elena S Addison ◽

Dylan N Clements

Keyword(s):

Clinical Setting ◽

Thermal Sensitivity ◽

Sensory Threshold ◽

Vertical Force ◽

Sensory Testing ◽

Sensitivity Testing ◽

Threshold Testing ◽

Quantitative Sensory Tests ◽

Sensory Tests ◽

Plate System

Objectives The aim of this study was to evaluate the repeatability of quantitative sensory tests (QSTs) in a group of healthy untrained cats (n = 14) and to compare the results with those from cats with osteoarthritis (n = 7). Methods Peak vertical force (PVF) and vertical impulse were measured on a pressure plate system. Thermal sensitivity was assessed using a temperature-controlled plate at 7°C and 40°C. Individual paw lifts and overall duration of paw lifts were counted and measured for each limb. Paw withdrawal thresholds were measured using manual and electronic von Frey monofilaments (MVF and EVF, respectively) applied to the metacarpal or metatarsal pads. All measurements were repeated twice to assess repeatability of the tests. Results In healthy cats all tests were moderately repeatable. When compared with cats with osteoarthritis the PVF was significantly higher in healthy hindlimbs in repeat 1 but not in repeat 2. Cats with osteoarthritis of the forelimbs showed a decrease in the frequency of paw lifts on the 7°C plate compared with cats with healthy forelimbs, and the duration of paw lifts was significantly less than healthy forelimbs in the first repeat but not in the second repeat. Osteoarthritic limbs had significantly lower paw withdrawal thresholds with both MVF and EVF than healthy limbs. Conclusions and relevance QSTs are moderately repeatable in untrained cats. Kinetic gait analysis did not permit differentiation between healthy limbs and those with osteoarthritis, but thermal sensitivity testing (cold) does. Sensory threshold testing can differentiate osteoarthritic and healthy limbs, and may be useful in the diagnosis and monitoring of this condition in cats in the clinical setting.

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Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury

The Journal of Rehabilitation Research and Development ◽

10.1682/jrrd.2005.08.0137 ◽

2007 ◽

Vol 44 (1) ◽

pp. 77 ◽

Cited By ~ 20

Author(s):

Gordana Savic ◽

Ebba M. K. Bergstrm ◽

Nick J. Davey ◽

Peter H. Ellaway ◽

Hans L. Frankel ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cord Injury ◽

Quantitative Sensory Tests ◽

Sensory Tests

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A Knowledge Translation Perspective on the Two Quantitative Sensory Tests and their Usability with Clinicians

Journal of Novel Physiotherapies ◽

10.4172/2165-7025.1000257 ◽

2015 ◽

Vol 05 (02) ◽

Cited By ~ 1

Author(s):

Zakir Uddin Joy C MacDermid

Keyword(s):

Knowledge Translation ◽

Quantitative Sensory Tests ◽

Sensory Tests

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Quantitative sensory tests fairly reflect immediate effects of oxycodone in chronic low-back pain

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.07.004 ◽

2017 ◽

Vol 17 (1) ◽

pp. 107-115 ◽

Cited By ~ 2

Author(s):

Jürg Schliessbach ◽

Andreas Siegenthaler ◽

Lukas Bütikofer ◽

Pascal Vuilleumier ◽

Peter Jüni ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Pain Threshold ◽

Detection Threshold ◽

Single Stimulus ◽

Low Back ◽

Pain Detection ◽

Quantitative Sensory Tests ◽

Sensory Tests

AbstractIntroductionQuantitative sensory tests (QST) can be used for profiling anti-nociceptive effects of analgesics. However, anti-nociceptive effects detected by QST are not necessarily associated with analgesic effects in pain patients. As part of a large investigation on low back pain, this paper describes the immediate analgesic and anti-nociceptive effects of oxycodone in chronic low-back pain and ranks different QST according to their ability to reflect this effect. The results are expected to support the selection of QST for future studies on potential novel opioid agonists in human pain.MethodsIn this randomized, placebo-controlled and double-blinded cross-over study, 50 patients with chronic low-back pain received a single oral dose of oxycodone 15 mg or active placebo, and underwent multiple QST testing. The intensity of low-back pain was recorded during 2 h. The areas under the ROC curves and 95% confidence intervals were determined, whereby responder status (≤30% pain reduction) was set as reference variable and changes in QST from baseline were set as classifiers.ResultsSignificant analgesic effect on low-back pain as well as anti-nociceptive effects for almost all QST parameters were observed. The QST with the highest area under the curve were heat pain detection threshold (0.65,95%-CI 0.46 to 0.83), single-stimulus electrical pain threshold (0.64,95%-CI 0.47 to 0.80) and pressure pain detection threshold (0.63,95%-CI 0.48 to 0.79).ConclusionsThe results suggest that anti-nociceptive effects assessed by QST fairly reflect clinical efficacy of oxycodone on low-back pain. Pressure pain detection threshold, heat pain detection threshold and single-stimulus electrical pain threshold may be more suitable to sort out potential non-responders rather than identifying potential responders to opioid medication. Future pre-clinical human research may consider these results when investigating the analgesic effect of opioid agonists by means of QST.

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A Simplified Diagnostic Classification Scheme of Chemotherapy-Induced Peripheral Neuropathy

Disease Markers ◽

10.1155/2020/3402108 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Han-Wei Huang ◽

Pei-Ying Wu ◽

Pei-Fang Su ◽

Chung-I Li ◽

Yu-Min Yeh ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Laboratory Tests ◽

Classification Scheme ◽

Gynecologic Cancer ◽

Unsupervised Classification ◽

Classification Algorithm ◽

Diagnostic Classification ◽

Laboratory Examinations ◽

Quantitative Sensory Tests ◽

Sensory Tests

Background and Objective. The main purpose of this study was to develop a simple automatic diagnostic classification scheme for chemotherapy-induced peripheral neuropathy. Methods. This was a prospective cohort study that enrolled patients with colorectal or gynecologic cancer post chemotherapy for more than 1 year. The patients underwent laboratory examinations (nerve conduction studies and quantitative sensory tests), and a questionnaire about the quality of life. An unsupervised classification algorithm was used to classify the patients into groups using a small number of variables derived from the laboratory tests. A panel of five neurologists also diagnosed the types of neuropathies according to the laboratory tests. The results by the unsupervised classification algorithm and the neurologists were compared. Results. The neurologists’ diagnoses showed much higher rates of entrapment syndromes (66.1%) and radiculopathies (55.1%) than polyneuropathy (motor/sensory: 33.1%/29.7%). A multivariate analysis showed that the questionnaire was not significantly correlated with the results of quantitative sensory tests (r=0.27) or the neurologists’ diagnoses (r=0.2). All of the patients were classified into four groups by the unsupervised classification algorithm. The classification corresponded to the severity of neuropathy and correlated well with the neurologists’ diagnoses and the scales of neurological examinations. The overall correct rate of classification by the unsupervised classification algorithm was 78.8% (95% confidence interval: 73.1%-88.3%). Conclusion. The results of our unsupervised classification algorithm based on three variables of laboratory tests correlated well with the neurologists’ diagnoses.

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