Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus

Miroslav Misha Backonja, Nadine Attal, Ralf Baron, Didier Bouhassira, Mark Drangholt, Peter J. Dyck, Robert R. Edwards, Roy Freeman, Richard Gracely, Maija H. Haanpaa, Per Hansson, Samar M. Hatem, Elena K. Krumova, Troels S. Jensen, Christoph Maier, Gerard Mick, Andrew S. Rice, Roman Rolke, Rolf Detlef Treede, Jordi SerraThomas Toelle, Valeri Tugnoli, David Walk, Mark S. Walalce, Mark Ware, David Yarnitsky, Dan Ziegler

Research output: Contribution to journalArticle

259 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1807-1819
Number of pages13
JournalPain
Volume154
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Chronic pain
  • Neuropathic pain
  • Quantitative sensory testing
  • Recommendations
  • Sensory neuropathies

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Backonja, M. M., Attal, N., Baron, R., Bouhassira, D., Drangholt, M., Dyck, P. J., Edwards, R. R., Freeman, R., Gracely, R., Haanpaa, M. H., Hansson, P., Hatem, S. M., Krumova, E. K., Jensen, T. S., Maier, C., Mick, G., Rice, A. S., Rolke, R., Treede, R. D., ... Ziegler, D. (2013). Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus. Pain, 154(9), 1807-1819. https://doi.org/10.1016/j.pain.2013.05.047