Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury

Savić, Gordana; Bergström, Ebba; Davey, Nick J.; Ellaway, P H; Frankel, H L; Jamous, Ali; Nicotra, Alessia

doi:10.1682/jrrd.2005.08.0137

Cited by 24 publications

(12 citation statements)

References 15 publications

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“…For this purpose, quantitative sensory testing (QST), dermatomal SSEPs (dSSEPS), and contact heat evoked potentials (CHEPs) have been investigated. 108 Quantitative Sensory Testing (QST) 109,110 involves administration of three types of stimuli to determine the threshold of detection of electrical, thermal and vibratory stimuli at the ASIA key sensory points in different dermatomes. This testing is based on the subject's report of perception differing from EP testing that measures evoked signals.…”

Section: Level Of Injurymentioning

confidence: 99%

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

Krishna

Andrews

Varma

et al. 2014

Journal of Neurotrauma

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The preservation of functional neural tissue after spinal cord injury (SCI) is the basis for spontaneous neurological recovery. Some injured patients in the acute phase have more potential for recovery than others. This fact is problematic for the construction of clinical trials because enrollment of subjects with variable recovery potential makes it difficult to detect effects, requires large sample sizes, and risks Type II errors. In addition, the current methods to assess injury and recovery are non-quantitative and not sensitive. It is likely that therapeutic combinations will be necessary to cause substantially improved function after SCI, thus we need highly sensitive techniques to evaluate changes in motor, sensory, autonomic and other functions. We review several emerging neurophysiological techniques with high sensitivity. Quantitative methods to evaluate residual tissue sparing after severe acute SCI have not entered widespread clinical use. This reduces the ability to correlate structural preservation with clinical outcome following SCI resulting in enrollment of subjects with varying patterns of tissue preservation and injury into clinical trials. We propose that the inclusion of additional measures of injury severity, pattern, and individual genetic characteristics may enable stratification in clinical trials to make the testing of therapeutic interventions more effective and efficient. New imaging techniques to assess tract injury and demyelination and methods to quantify tissue injury, inflammatory markers, and neuroglial biochemical changes may improve the evaluation of injury severity, and the correlation with neurological outcome, and measure the effects of treatment more robustly than is currently possible. The ability to test such a multimodality approach will require a high degree of collaboration between clinical and research centers and government research support. When the most informative of these assessments is determined, it may be possible to identify patients with substantial recovery potential, improve selection criteria and conduct more efficient clinical trials.

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Section: Level Of Injurymentioning

confidence: 99%

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

Krishna

Andrews

Varma

et al. 2014

Journal of Neurotrauma

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“…[57][58][59][60] AGEING AND SURVIVAL Together with the Northwest Regional Spinal Injuries Centre, Southport, UK, and in collaboration with Craig Hospital, Englewood, CO, USA, we have undertaken a longitudinal study on Ageing with SCI in order to provide information on health, functional ability and psychosocial wellbeing in persons with long-term spinal cord injury. 61 In 1990, when the study started, all participants had been injured more than 20 years previously.…”

Section: Psychologymentioning

confidence: 99%

The Sir Ludwig Guttmann Lecture 2012: the contribution of Stoke Mandeville Hospital to spinal cord injuries

Frankel

2012

Spinal Cord

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“…Although neurophysiological measures of body function/structure have not shown promise in some acute studies, 45 they may have value in persons with chronic SCI. 55 Quantitative sensory 56,57 and motor testing procedures also offer promise of greater precision. Recent advances in neuroimaging of SCI hold promise for development of anatomical/physiological surrogates of the severity of injury for use in clinical trials.…”

Section: Evolution Of Outcome Measures In Randomized Multicenter Clinmentioning

confidence: 99%

Outcome measures: evolution in clinical trials of neurological/functional recovery in spinal cord injury

Ditunno

2010

Spinal Cord

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The need to determine the beneficial effect of the treatment of spinal cord injury (SCI) requires clearly defined standardized measures of the severity of injury and how well the function is restored. Improved neurological recovery should be linked to increased capacity to perform tasks such as walking, reaching and grasping, which results in meaningful gains in mobility and self-care. Measurements of recovery, capacity, mobility and self-care are the outcomes used to determine the benefits from the treatment and have evolved over the last century with contributions by the mentors and protégés of Sir Ludwig Guttmann, whom we honor today. Randomized clinical trials in the past 20 years have taught us many lessons as to which outcome measures have the greatest validity and reliability. The International Standards for Neurological Classification of SCI have become the clinical gold standard for measurement of severity, but would benefit from pathophysiological surrogates to better understand the mechanisms of recovery. Measurements of walking capacity have emerged as valid/reliable/ responsive and upper extremity measures are in development, which help distinguish neurological improvement from rehabilitation adaptation. Performance of self-care and mobility has been linked to capacity and severity outcomes. In addition, new partnerships between clinical trial entities, professional societies, industry and federal agencies should facilitate identification of priorities and uniformity of measurement standards. Our ultimate goal is to improve the quality of life of those individuals with SCI whom we serve, but we must focus our investigative efforts carefully, systematically and rigorously as clinical scientists.

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Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury

Abstract: Abstract-This

Cited by 24 publications

References 15 publications

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

The Sir Ludwig Guttmann Lecture 2012: the contribution of Stoke Mandeville Hospital to spinal cord injuries

Outcome measures: evolution in clinical trials of neurological/functional recovery in spinal cord injury

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