TY - JOUR
T1 - Value of quantitative sensory testing in neurological and pain disorders
T2 - NeuPSIG consensus
AU - Backonja, Miroslav Misha
AU - Attal, Nadine
AU - Baron, Ralf
AU - Bouhassira, Didier
AU - Drangholt, Mark
AU - Dyck, Peter J.
AU - Edwards, Robert R.
AU - Freeman, Roy
AU - Gracely, Richard
AU - Haanpaa, Maija H.
AU - Hansson, Per
AU - Hatem, Samar M.
AU - Krumova, Elena K.
AU - Jensen, Troels S.
AU - Maier, Christoph
AU - Mick, Gerard
AU - Rice, Andrew S.
AU - Rolke, Roman
AU - Treede, Rolf Detlef
AU - Serra, Jordi
AU - Toelle, Thomas
AU - Tugnoli, Valeri
AU - Walk, David
AU - Walalce, Mark S.
AU - Ware, Mark
AU - Yarnitsky, David
AU - Ziegler, Dan
N1 - Funding Information:
Ralf Baron, Christoph Maier, Thomas Tölle, and Rolf Detlef Treede have received a grant from BMBF for developing and using a standardized QST paradigm (DFNS).
PY - 2013/9
Y1 - 2013/9
N2 - 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.
AB - 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.
KW - Chronic pain
KW - Neuropathic pain
KW - Quantitative sensory testing
KW - Recommendations
KW - Sensory neuropathies
UR - http://www.scopus.com/inward/record.url?scp=84881663336&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84881663336&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2013.05.047
DO - 10.1016/j.pain.2013.05.047
M3 - Article
C2 - 23742795
AN - SCOPUS:84881663336
SN - 0304-3959
VL - 154
SP - 1807
EP - 1819
JO - Pain
JF - Pain
IS - 9
ER -