Quantitative Sensory Testing and Pain Management

2020 ◽  
Vol 103 (8) ◽  
pp. 837-843
Keyword(s):  
Neuropathic Pain ◽  
Quantitative Sensory Testing ◽  
Somatosensory System ◽  
Neuropathischer Schmerz ◽  
Sensory Profile ◽  
Research Network ◽  
Sensory Testing ◽  
C Fibers ◽  
Bedside Method ◽  
Sensory Profiles

Quantitative sensory testing (QST) is a psychophysical assessment of somatosensory system that complements neurological sensory examination. The information derived from QST presents the function of unmyelinated C-fibers, small myelinated Aδ-fibers, and large myelinated Aβ-fibers including their central pathways to the brain. QST may be performed by simple bedside method and by standardized method developed from the German Research Network on Neuropathic Pain (Deutscher Forschungsverbund Neuropathischer Schmerz, DFNS). The standardized QST makes it possible to subgroup patients with peripheral neuropathic pain of different etiologies according to sensory profiles with emerging evidence showing predictive value of QST for treatment efficacy. Keywords: Quantitative sensory testing, Neuropathic pain, Sensory profile

scholarly journals Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function

2021 ◽  
Vol 10 (2) ◽  
pp. 239
Author(s):  
Dalia Rega ◽  
Mika Aiko ◽  
Nicolás Peñaranda ◽  
Amparo Urios ◽  
Juan-José Gallego ◽  
...  
Keyword(s):  
Nervous System ◽  
Hepatic Encephalopathy ◽  
Quantitative Sensory Testing ◽  
Autonomic Function ◽  
Thermal Sensitivity ◽  
Somatosensory System ◽  
Minimal Hepatic Encephalopathy ◽  
Heat Pain ◽  
Sensory Testing ◽  
Cirrhotic Patients

Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibration, cooling, and heat pain detection) by electromyography and quantitative sensory testing. The detection thresholds for cold and heat pain on the foot were higher in patients with, than those without MHE. This hyposensitivity was correlated with attention deficits. Reaction times in the foot were longer in patients with, than without MHE. Patients with normal sural nerve amplitude showed altered thermal sensitivity and autonomic function, with stronger alterations in patients with, than in those without MHE. MHE patients show a general decrease in cognitive and sensory abilities. Small fibers of the autonomic nervous system and thermal sensitivity are altered early on in MHE, before large sensory fibers. Quantitative sensory testing could be used as a marker of MHE.

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.

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