Quantitative sensory testing: a comprehensive protocol for clinical trials
Quantitative sensory testing: a comprehensive protocol for clinical trials
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DOI：
10.1016/j.ejpain.2005.02.003
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发表时间：
2006-01-01
影响因子：
3.6
通讯作者：
Treede, RD
中科院分区：
文献类型：
--
作者：
Rolke, R;Magerl, W;Treede, RD
我们已经编制了一个全面的QST方案，作为德国神经病理性疼痛(DFNS)研究网络的一部分，使用了几乎所有躯体感觉方面的成熟测试。该协议包括热测试程序和机械测试程序。我们的基本原理是测试感觉丧失(大小神经纤维功能)或获得(痛觉过敏、超感、超感)的模式，并评估皮肤和深层疼痛的敏感性。QST方案的实用性在18名21-58岁的健康受试者中进行了测试。其中一半是女性。所有受试者都接受了面部、手部和脚部的双侧测试。我们测定了热感觉和痛阈值，包括对存在反常热感的测试，对冯-弗雷细丝和-赫兹音叉的机械检测阈值，对针刺刺激和钝化压力的机械痛阈值，对针刺和动态机械超敏(对光触摸的疼痛)的刺激反应函数，以及使用重复针刺刺激的疼痛总和(发条率)。整个方案每个测试区花费27+/-2.3分钟。大多数QST参数仅在对数变换(二次归一化)后才呈正态分布，但出现反常热感觉、冷痛觉、热痛觉和振动检测阈值的频率除外。阈值通常最低的是面部，其次是手，然后是脚。只有热痛觉阈值、发条比率和振动检测阈值与身体部位没有显著关系。所有QST参数从右到左没有显著差异；从左到右的相关系数在0.78到0.97之间。因此可以解释61%到94%的差异。这项研究表明，一个受影响区域和一个未受影响的对照区域的完整体感轮廓可以在1小时内获得，这将是表征各种疾病的患者所必需的。选定患者的案例例子说明了z变换QST数据对于简单地调查个体症状轮廓的价值。(C)2005年国际疼痛研究协会欧洲分会联合会。爱思唯尔有限公司出版。保留所有权利。
We have compiled a comprehensive QST protocol as part of the German Research Network on Neuropathic Pain (DFNS) using well established tests for nearly all aspects of somatosensation. This protocol encompasses thermal as well as mechanical testing procedures. Our rationale was to test for patterns of sensory loss (small and large nerve fiber functions) or gain (hyperalgesia, allodynia, hyperpathia), and to assess both cutaneous and deep pain sensitivity. The practicality of the QST protocol was tested in 18 healthy subjects, 21-58 years. half of them female. All Subjects were tested bilaterally over face, hand and foot. We determined thermal detection and pain thresholds including a test for the presence of paradoxical heat sensations, mechanical detection thresholds to von Frey filaments and a 64-Hz tuning fork, mechanical pain thresholds to pinprick stimuli and blunt pressure, stimulus-response-functions for pinprick and dynamic mechanical allodynia (pain to light touch), and pain summation (wind-up ratio) using repetitive pinprick stimulation.The full protocol took 27 +/- 2.3 min per test area. The majority of QST parameters were normally distributed only after logarithmic transformation (secondary normalization) except for the frequency of paradoxical heat sensations, cold and heat pain thresholds, and for vibration detection thresholds. Thresholds were usually lowest over face, followed by hand, and then foot. Only thermal pain thresholds, wind-up ratio and vibration detection thresholds were not significantly dependent on the body region. There was no significant right-to-left difference for any of the QST parameters; left-to-right correlation coefficients ranged between 0.78 and 0.97. thus explaining between 61% and 94% of the variance. This study has shown that a complete somatosensory profile of one affected area and one unaffected control area, which will be necessary to characterize patients with a variety of diseases, can be obtained within 1 h. Case examples of selected patients illustrate the value of z-transformed QST data for an easy survey of individual symptom profiles. (C) 2005 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.