Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus
Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus
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DOI：
10.1016/j.pain.2013.05.047
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发表时间：
2013-09-01
期刊：
影响因子：
7.4
通讯作者：
Ziegler, Dan
中科院分区：
文献类型：
--
作者：
Backonja, Miroslav 'Misha'';Attal, Nadine;Ziegler, Dan
定量感觉测试(QST)是一种用来量化健康受试者和患者对受控刺激反应的躯体感觉功能的心理物理方法。虽然QST与在临床实践和研究中广泛使用的听觉或视力的定量评估有相似之处，但由于许多原因，它并没有在临床医生中获得广泛的接受，而且在很大程度上是因为缺乏关于执行QST的标准、其潜在效用和结果解释的信息。国际疼痛研究协会(NeuPSIG)的神经病理性疼痛特别兴趣小组召开了协商一致的会议，以制定在临床实践和研究中实施QST的建议。研究证实，QST可用于评估和监测躯体感觉缺陷，特别是在糖尿病和小纤维神经病中；评估诱发疼痛(机械和热痛或痛觉过敏)；以及诊断感觉神经疾病。有前景的应用包括在大规模临床试验中对诱发疼痛的评估和对条件性疼痛调制的研究。在临床实践中，我们建议使用QST来筛查小纤维和大纤维神经病；监测躯体感觉缺陷；监测诱发疼痛、超敏和痛觉过敏。不推荐将QST作为诊断神经病理性疼痛的独立测试。对于健康受试者和患者的QST，我们建议使用预定义的标准化刺激和说明、经过验证的测试算法和根据解剖位置、年龄和性别校正的参考值。对结果的解释应始终考虑到临床情况，有语言和认知困难、焦虑或诉讼的患者不应被认为符合QST的条件。当应用这里讨论的适当标准时，QST可以提供有关体感系统功能状态的重要而独特的信息，这将是对现有临床方法的补充。(C)2013年国际疼痛研究协会。爱思唯尔出版，版权所有。
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. 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. (c) 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.