Quantitative Sensory Testing in Pain Management

Roldan, Carlos J.; Abdi, Salahadin

doi:10.2217/pmt.15.37

Cited by 13 publications

(5 citation statements)

References 58 publications

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“…Pain assessment and diagnostic guidelines propose the use of objective measurable tests such as quantitative sensory testing (QST, Table 1) to support the diagnosis of neuropathic pain (Cruccu et al, 2010;Cruccu & Truini, 2009;Finnerup et al, 2016;Haanpaa et al, 2011;Piano et al, 2012Piano et al, , 2013. QST has been used most frequently in the assessment of peripheral neuropathic pain syndromes to define thermal and mechanical stimuli (Roldan & Abdi, 2015;Rolke et al, 2006b). In cancer, QST has primarily focused on the assessment of peripheral neuropathy associated with exposure to chemotherapy (Augusto et al, 2008;Boyette-Davis et al, 2013, 2011bLipton et al, 1987Lipton et al, , 1991Vichaya et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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Objective To summarize the literature on the use of quantitative sensory testing (QST) in the assessment of pain in people with cancer and to describe which QST parameters consistently demonstrate abnormal sensory processing in patients with cancer pain. Databases and Data Treatment Medline, EMBASE, AMED, CINAHL, SCOPUS and CENTRAL were searched for observational or experimental studies using QST in patients with a cancer diagnosis and reporting pain. Search strategies were based on the terms “quantitative sensory testing”, “cancer”, “pain”, “cancer pain” and “assessment”. Databases were searched from inception to January 2019. Data were extracted and synthesized narratively, structured around the different QST modalities and sub‐grouped by cancer pain aetiology (tumour‐ or treatment‐related pain). Results Searches identified 286 records of which 18 met the eligibility criteria for inclusion. Three studies included patients with tumour‐related pain, and 15 studies included patients with pain from chemotherapy‐induced peripheral neuropathy (CIPN). Across all studies, 50% (9/18) reported sensory abnormities using thermal detection thresholds (cool and warm), 44% (8/18) reported abnormal mechanical detection thresholds using von‐Frey filaments and 39% (7/18) found abnormal pinprick thresholds. Abnormal vibration and thermal pain (heat/cold) thresholds were each reported in a third of included studies. Conclusion This systematic review highlights the lack of published data characterizing the sensory phenotype of tumour‐related cancer pain. This has implications for our understanding of the underlying pathophysiological mechanisms of cancer pain. Understanding the multiple mechanisms driving cancer pain will help to move towards rational individualized analgesic treatment choices. Significance This systematic review found that pain in cancer patients is associated with abnormal sensory responses to thermal, mechanical and pinprick stimuli. However, these findings are based primarily on studies of chemotherapy‐induced peripheral neuropathy and data on tumour‐related pain are lacking, warranting further research.

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Section: Introductionmentioning

confidence: 99%

The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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“…QST is a noninvasive assessment of sensory and pain perception that relies on the analysis of an individual's response to external stimuli. 34 The QST includes a battery of tests that quantify the function of the somatosensory nervous system and assess various characteristics of nociceptive and non-nociceptive submodalities, which are supported by different groups of afferent nerve fibers and central pathways. In this protocol, we utilized detection threshold measurements of light touch detection thresholds, sharpness weight detection, pressure, and temperature-evoked pain.…”

Section: Study Endpointsmentioning

confidence: 99%

The impact of scrambler therapy on pain and quality of life for chemotherapy‐induced peripheral neuropathy: A pilot study

Chung,

Chen,

Wang

et al. 2024

Pain Practice

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BackgroundChemotherapy‐induced peripheral neuropathy (CIPN) is a debilitating disturbance among patients who received chemotherapy, with no effective treatment available. Scrambler therapy (ST) is a noninvasive treatment capable of improving multiple quality‐of‐life symptoms beyond pain. We aimed to evaluate the efficacy of ST for pain and nonpain symptoms related to CIPN.MethodsTen patients with moderate to severe CIPN symptoms for >3 months were enrolled in a single‐arm trial of ST for 10 daily sessions. CIPN‐related symptoms were measured throughout the treatment period and up to 6 months thereafter.ResultsThe worst pain was reduced by 6 months (p = 0.0039). QST demonstrated the greatest improvement in pressure of 60 g (p = 0.308, Cohen's d = 0.42) and cold temperature threshold of 2.5°C (p = 0.9375, Cohen's d = 0.51) in the gastrocnemius area. Symptoms of numbness, tingling, trouble walking, and disturbed sleep had significant improvements at 6 months. Pain medication use decreased by 70% at the end of treatment and by 42% at 6 months. Patient satisfaction was high (82%) and no adverse events with ST treatment were reported.ConclusionsThe results of this pilot trial support the use of ST by demonstrating improvement in multiple domains of quality of life for CIPN patients during an extended follow‐up of 6 months. However, further large‐scale studies are needed to confirm our findings.

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“…In contrast to previous studies assessing long-term reliability of QST parameters [18,19], the present study included a standardized procedure to introduce the algometer and PPT measures to the participants, as has been suggested previously [34]. Rigorous methodology is key to generating reliable outcomes in psychophysical testing, as many testing procedures are operator-dependent [42]. For this reason, the simplicity of procedures, such as that used for PPT here, may be highly relevant if sensory testing is to be implemented into clinical practice.…”

Section: Long-term Reliabilitymentioning

confidence: 99%

“…For this reason, the simplicity of procedures, such as that used for PPT here, may be highly relevant if sensory testing is to be implemented into clinical practice. Psychophysical tests are influenced by affective and cognitive factors, which may change over time [42]. Marcuzzi and colleagues assessed psychosocial factors at baseline, but none of the previous long-term reliability studies investigated whether changes in psychosocial variables occurred during their assessment period [18,19].…”

Section: Long-term Reliabilitymentioning

confidence: 99%

Long-term consistency of clinical sensory testing measures for pain assessment

et al. 2023

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Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short-and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

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Quantitative Sensory Testing in Pain Management

Cited by 13 publications

References 58 publications

The use of quantitative sensory testing in cancer pain assessment: A systematic review

The use of quantitative sensory testing in cancer pain assessment: A systematic review

The impact of scrambler therapy on pain and quality of life for chemotherapy‐induced peripheral neuropathy: A pilot study

Long-term consistency of clinical sensory testing measures for pain assessment

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