scholarly journals Quantitative sensory testing predicts histological small fiber neuropathy in postural tachycardia syndrome

2019 ◽  
Vol 10 (5) ◽  
pp. 428-434
Author(s):  
Sophia C.I. Billig ◽  
Joana C. Schauermann ◽  
Roman Rolke ◽  
Istvan Katona ◽  
Jörg B. Schulz ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Detection Threshold ◽  
Small Fiber Neuropathy ◽  
Sensory Testing ◽  
Cold Pain ◽  
Noninvasive Test ◽  
Small Fiber ◽  
Heat Pain Threshold

BackgroundRetrospective investigation of the somatosensory profile and prediction of histologic small fiber neuropathy (SFN) in postural orthostatic tachycardia syndrome (POTS) was performed using quantitative sensory testing (QST) as a standardized noninvasive test.MethodsIn this investigation, full data sets from 30 patients (age: 34.03 ± 10.82 years, n = 6 males), including results of autonomic function testing, norepinephrine values, skin biopsy, and QST, were retrospectively analyzed. The QST data were compared with healthy controls (HCs) (age: 34.20 ± 10.5 years, n = 6 males, t test: 0.95).ResultsThe evaluation of all QST parameters in POTS compared with HCs yielded differences in all thermal parameters (cold detection threshold: p < 0.05, warm detection threshold: p < 0.001, thermal sensory limen: p < 0.001, cold pain threshold: p < 0.05, and heat pain threshold: p < 0.001) and in paradoxical heat sensations (p < 0.05). Differences in nonpainful stimuli (mechanical detection threshold: p < 0.05 and vibration detection threshold: p < 0.001) were also detected. All patients who had clinical signs of SFN in combination with impairment of small fibers in QST also had SFN on skin biopsy.ConclusionThese results suggest that a non–region-specific SFN in POTS compared with controls can be detected by noninvasive QST that predicts histologic small fiber pathology.

scholarly journals Thermal Quantitative Sensory Testing in Fibromyalgia Patients / Termāla Kvantitatīva Sensora Testēšana Fibromialģijas Pacientiem

2015 ◽  
Vol 69 (5) ◽  
pp. 215-222
Author(s):  
Marija Mihailova ◽  
Ināra Logina ◽  
Santa Rasa ◽  
Svetlana Čapenko ◽  
Modra Murovska ◽  
...  
Keyword(s):  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Fibromyalgia Impact Questionnaire ◽  
Sensory System ◽  
Thermal Stimulus ◽  
Thermal Perception ◽  
Sensory Testing ◽  
Inhibitory System ◽  
Cold Pain ◽  
Heat Pain Threshold

AbstractFibromyalgia (FM) is a chronic disorder manifested by diffuse musculoskeletal pain, fatigue, sleep, and emotional disturbance. The disorder is probably associated with dysfunction of C and A delta peripheral nerve fibres. Thermal quantitative sensory testing (QST) was used to analyse thinly myelinated A delta fibres and nonmylinated C fibres, which function in the nociceptive sensory system, and the spinothalamic pathway. The observation that FM pain has neuropathic nature increased the value of QST as an additional diagnostic tool. The research group included 51 patients. Somatic symptoms were assessed using the Fatigue Severity Score (FSS), Fibromyalgia Impact Questionnaire (FIQ) and American College of Rheumatology (ACR) 2010 year diagnostic criteria. QST was performed by using thermal stimulus at wrist and feet. QST results were compared with 20 non-FM controls matched for age and sex. FM patients showed significant alteration of thermal perception and pain threshold compared with that in healthy controls, which demonstrated possible neuropathic pain nature in FM patients. Changes were more expressed in warm perception and heat pain threshold, which probably indicates that in FM patients C fibres are more damaged and warm perception and warm pain threshold are more sensitive, which may be used as FM diagnostics. We also found statistically significant negative correlations between warm and cold perception thresholds and between heat and cold pain thresholds, reflecting central sensitization or a defective pain inhibitory system.

Quantitative Sensory Testing in Patients with Multisomatoform Disorder with Chronic Pain as the Leading Bodily Symptom—a Matched Case–Control Study

Pain Medicine ◽  
2019 ◽  
Author(s):  
Johannes Achenbach ◽  
Anh-Thu Tran ◽  
Burkhardt Jaeger ◽  
Karl Kapitza ◽  
Michael Bernateck ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Somatoform Disorders ◽  
Detection Threshold ◽  
Pressure Pain Threshold ◽  
Sensory Profile ◽  
Sensory Loss ◽  
Sensory Testing ◽  
Presenting Symptoms

Abstract Objective Chronic pain is a debilitating condition of multifactorial origin, often without physical findings to explain the presenting symptoms. Of the possible etiologies of persisting painful symptoms, somatoform disorders and functional somatic syndromes (FSS) are among the most challenging, with a prevalence of 8–20%. Many different somatoform disorders and FSS have overlapping symptoms, with pain being the most prevalent one. The concept of multisomatoform disorder (MSD) has been developed to acknowledge that fact. We hypothesized that the concept of MSD will be reflected in a distinct sensory profile of patients compared with healthy controls and possibly provide insight into the type and pathophysiology of the pain commonly experienced by patients. Design We performed comprehensive quantitative sensory testing (QST) in 151 patients and 149 matched controls. Results There were significant differences in the sensory profiles of patients compared with controls. Patients with MSD showed a combination of tactile and thermal hypesthesia combined with mechanical and cold hyperalgesia. This was true for measurements at test and control sites, with the exception of vibration detection threshold and mechanical pain threshold. Among the observed changes, a marked sensory loss of function, as evidenced by an increase in cold detection threshold, and a marked gain of function, as evidenced by a decrease of pressure pain threshold, were most notable. There was no evidence of concurrent medication influencing QST results. Conclusions The observed somatosensory profile of patients with MSD resembles that of patients suffering from neuropathic pain with evidence of central sensitization.

scholarly journals Mechanical punctate pain threshold is associated with headache frequency and phase in patients with migraine

Cephalalgia ◽  
2020 ◽  
Vol 40 (9) ◽  
pp. 990-997
Author(s):  
Li-Ling Hope Pan ◽  
Yen-Feng Wang ◽  
Kuan-Lin Lai ◽  
Wei-Ta Chen ◽  
Shih-Pin Chen ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Healthy Controls ◽  
Sensory Testing ◽  
Dynamic Changes ◽  
Cold Pain ◽  
Pain Thresholds

Objective Previous studies regarding the quantitative sensory testing are inconsistent in migraine. We hypothesized that the quantitative sensory testing results were influenced by headache frequency or migraine phase. Methods This study recruited chronic and episodic migraine patients as well as healthy controls. Participants underwent quantitative sensory testing, including heat, cold, and mechanical punctate pain thresholds at the supraorbital area (V1 dermatome) and the forearm (T1 dermatome). Prospective headache diaries were used for headache frequency and migraine phase when quantitative sensory testing was performed. Results Twenty-eight chronic migraine, 64 episodic migraine and 32 healthy controls completed the study. Significant higher mechanical punctate pain thresholds were found in episodic migraine but not chronic migraine when compared with healthy controls. The mechanical punctate pain thresholds decreased as headache frequency increased then nadired. In episodic migraine, mechanical punctate pain thresholds were highest ( p < 0.05) in those in the interictal phase and declined when approaching the ictal phase in both V1 and T1 dermatomes. Linear regression analyses showed that in those with episodic migraine, headache frequency and phase were independently associated with mechanical punctate pain thresholds and accounted for 29.7% and 38.9% of the variance in V1 ( p = 0.003) and T1 ( p < 0.001) respectively. Of note, unlike mechanical punctate pain thresholds, our study did not demonstrate similar findings for heat pain thresholds and cold pain thresholds in migraine. Conclusion Our study provides new insights into the dynamic changes of quantitative sensory testing, especially mechanical punctate pain thresholds in patients with migraine. Mechanical punctate pain thresholds vary depending on headache frequency and migraine phase, providing an explanation for the inconsistency across studies.

scholarly journals Differences in Somatosensory Function During Premenopause and Early and Late Postmenopause in Patients With Burning Mouth Syndrome

2021 ◽  
Author(s):  
Kana Ozasa ◽  
Noboru Noma ◽  
Kosuke Watanabe ◽  
Andrew Young ◽  
Eli Eliav ◽  
...  
Keyword(s):  
Pain Threshold ◽  
Detection Threshold ◽  
Burning Mouth Syndrome ◽  
Cold Pain ◽  
Heat Pain Threshold ◽  
Z Scores ◽  
Burning Mouth ◽  
Thermal Stimuli ◽  
Burning Mouth Sensation ◽  
Somatosensory Function

Abstract Background: This study aimed to examine the association between somatosensory dysfunction and burning mouth syndrome (BMS) in premenopausal, early postmenopausal, and late postmenopausal patients, using a standardized Quantitative Sensory Testing (QST) protocol, and to determine the predictive value of thermal or mechanical perception by QST for detecting BMS.Methods: The study included 36 female participants with BMS (12 premenopausal, 10 early postmenopausal, and 14 late postmenopausal) and 42 age- and sex- matched healthy volunteers (21 premenopausal, 10 early postmenopausal, and 11 late postmenopausal). Neurophysiological tests were used to evaluate somatosensory dysfunction at the tongue.Results: Z-scores in the late postmenopausal BMS group revealed a gain of function for the cold pain threshold and heat pain threshold (Z=2.08 and 3.38, respectively). In the multiple regression analysis with the Visual Analogue Scale as the dependent variable, the vibration detection threshold predicted severity of burning mouth sensation in the premenopausal group.Conclusions: Late postmenopausal patients with BMS showed an increased response of the tongue to noxious thermal stimuli. This supports the theory that changes in sex hormones may affect trigeminal somatosensory function in particular, during the late postmenopausal stage in patients with BMS.

scholarly journals Local and Systemic Analgesic Effects of Nerve-Specific Acupuncture in Healthy Adults, Measured by Quantitative Sensory Testing

Pain Medicine ◽  
2019 ◽  
Author(s):  
Alexandra Dimitrova ◽  
Dana Dharmakaya Colgan ◽  
Barry Oken
Keyword(s):  
Dose Response ◽  
Repeated Measures ◽  
Quantitative Sensory Testing ◽  
Pain Perception ◽  
Detection Threshold ◽  
High Dose ◽  
Heat Pain ◽  
Sensory Testing ◽  
Analgesic Effects ◽  
Heat Pain Threshold

Abstract Objective  This study aims to assess whether acupuncture analgesia’s effects are local or systemic and whether there is a dose response for these effects. Methods  Twenty-eight healthy volunteers aged 18–45 were randomized to two doses of acupuncture using points closely associated with peripheral nerves in the legs. The lower-dose group involved acupoints overlying the deep peroneal nerve (DP), and the higher-dose involved acupoints overlying the deep peroneal and posterior tibial nerves (DPTN). Baseline and acupuncture quantitative sensory testing (QST) assessments were obtained locally in the calf and great toe and systemically in the hand. Results were analyzed using factorial repeated-measures analysis of variance for each of the QST variables—cold detection threshold (CDT), vibration detection threshold (VDT), heat pain threshold (HP0.5), and heat pain perception of 5/10 (HP5.0). Location (leg/hand) and time (baseline/acupuncture) were within-subject factors. Intervention (DP/DPTN) was a between-subject factor. Results  CDT was increased in the calf (P < 0.001) and in the hand (P < 0.001). VDT was increased in the toe (P < 0.001) but not in the hand. HP0.5 was increased in the calf (P < 0.001) and in the hand (P < 0.001). HP5.0 was increased in the calf (P = 0.002) and in the hand (P < 0.001), with the local effect being significantly greater than the systemic (P = 0.004). In all of the above QST modalities, there was no difference between the low-dose (DP) and high-dose (DPTN) acupuncture groups. Conclusions  Acupuncture caused comparable local and systemic analgesic effects in cold detection and heat pain perception and only local effects in vibration perception. There was no clear acupuncture dose response to these effects.

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