Validation of a Brazilian quantitative sensory testing (QST) device for the diagnosis of small fiber neuropathies

Schestatsky, Pedro; Stefani, Luciana Cadore; Sanches, Paulo Roberto Stefani; Júnior, Danton Pereira da Silva; Torres, Iraci Lucena da Silva; Dall'Agnol, Letizzia; Balbinot, Luciane Fachin; Caumo, Wolnei

doi:10.1590/s0004-282x2011000700019

Cited by 38 publications

(49 citation statements)

References 28 publications

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“…The authors (MUW and JMB) independently from the abstracts retrieved 17 references, in which test‐retest assessments of one or more QST variables were made and where the statistical methods were adequately described. The 17 articles were reviewed in full, and 16 of these were found relevant and included in this review.…”

Section: Resultsmentioning

confidence: 99%

Test-retest studies in quantitative sensory testing: a critical review

Werner

Petersen

Bischoff

2013

Acta Anaesthesiol Scand

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Quantitative sensory testing (QST) investigates the graded psychophysical response to controlled thermal, mechanical, electrical or chemical stimuli, allowing quantification of clinically relevant perception and pain thresholds. The methods are ubiquitously used in experimental and clinical pain research, and therefore, the need for uniform assessment procedures has been emphasised. However, varying consistency and transparency in the statistical methodology seem to occur in the QST literature. Sixteen publications, evaluating aspects of QST variability, from 2010 to 2012, were critically reviewed in detail. A considerable heterogeneity in the statistical evaluations of test-retest data was demonstrated. The authors, using a secondary analysis of published data for didactic purposes, propose and present minimal requirements for reporting of test-retest QST data.

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Section: Resultsmentioning

confidence: 99%

Test-retest studies in quantitative sensory testing: a critical review

Werner

Petersen

Bischoff

2013

Acta Anaesthesiol Scand

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“…c) Quantitative Sensory Testing (QST) was used to assess heat pain thresholds using the method of limits with a computer Peltier-based device thermode (30 × 30 mm) [26] that was attached to the skin on the ventral aspect of the mid-forearm. The baseline temperature was set at 32°C and was increased at a rate of 1°C/s to a maximum of 52°C.…”

Section: Methodsmentioning

confidence: 99%

“…The patient had to report when she began to feel a warm sensation and when it became painful, with the latter representing the heat pain threshold (HPT). Three assessments were performed with an inter-stimuli interval of 40 seconds [26]. Each subject’s HPT was defined as the mean painful temperature of the three assessments.…”

Section: Methodsmentioning

confidence: 99%

Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

et al. 2014

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BackgroundThis study aimed to answer three questions related to chronic myofascial pain syndrome (MPS): 1) Is the motor cortex excitability, as assessed by transcranial magnetic stimulation parameters (TMS), related to state-trait anxiety? 2) Does anxiety modulate corticospinal excitability changes after evoked pain by Quantitative Sensory Testing (QST)? 3) Does the state-trait anxiety predict the response to pain evoked by QST if simultaneously receiving a heterotopic stimulus [Conditional Pain Modulation (CPM)]? We included females with chronic MPS (n = 47) and healthy controls (n = 11), aged 19 to 65 years. Motor cortex excitability was assessed by TMS, and anxiety was assessed based on the State-Trait Anxiety Inventory. The disability related to pain (DRP) was assessed by the Profile of Chronic Pain scale for the Brazilian population (B:PCP:S), and the psychophysical pain measurements were measured by the QST and CPM.ResultsIn patients, trait-anxiety was positively correlated to intracortical facilitation (ICF) at baseline and after QST evoked pain (β = 0.05 and β = 0.04, respectively) and negatively correlated to the cortical silent period (CSP) (β = -1.17 and β = -1.23, respectively) (P <0.05 for all comparisons). After QST evoked pain, the DRP was positively correlated to ICF (β = 0.02) (P < 0.05). Pain scores during CPM were positively correlated with trait-anxiety when it was concurrently with high DRP (β = 0.39; P = 0.02). Controls’ cortical excitability remained unchanged after QST.ConclusionsThese findings suggest that, in chronic MPS, the imbalance between excitatory and inhibitory descending systems of the corticospinal tract is associated with higher trait-anxiety concurrent with higher DRP.

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“…Quantitative sensory testing (QST) was used to assess heat pain thresholds using the method of limits with a computer Peltier-based device thermode (30×30 mm) [21]. The thermode was attached to the skin on the ventral aspect of the mid-forearm.…”

Section: Methodsmentioning

confidence: 99%

A Phase II, Randomized, Double-Blind, Placebo Controlled, Dose-Response Trial of the Melatonin Effect on the Pain Threshold of Healthy Subjects

et al. 2013

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BackgroundPrevious studies have suggested that melatonin may produce antinociception through peripheral and central mechanisms. Based on the preliminary encouraging results of studies of the effects of melatonin on pain modulation, the important question has been raised of whether there is a dose relationship in humans of melatonin on pain modulation.ObjectiveThe objective was to evaluate the analgesic dose response of the effects of melatonin on pressure and heat pain threshold and tolerance and the sedative effects.MethodsSixty-one healthy subjects aged 19 to 47 y were randomized into one of four groups: placebo, 0.05 mg/kg sublingual melatonin, 0.15 mg/kg sublingual melatonin or 0.25 mg/kg sublingual melatonin. We determine the pressure pain threshold (PPT) and the pressure pain tolerance (PPTo). Quantitative sensory testing (QST) was used to measure the heat pain threshold (HPT) and the heat pain tolerance (HPTo). Sedation was assessed with a visual analogue scale and bispectral analysis.ResultsSerum plasma melatonin levels were directly proportional to the melatonin doses given to each subject. We observed a significant effect associated with dose group. Post hoc analysis indicated significant differences between the placebo vs. the intermediate (0.15 mg/kg) and the highest (0.25 mg/kg) melatonin doses for all pain threshold and sedation level tests. A linear regression model indicated a significant association between the serum melatonin concentrations and changes in pain threshold and pain tolerance (R2 = 0.492 for HPT, R2 = 0.538 for PPT, R2 = 0.558 for HPTo and R2 = 0.584 for PPTo).ConclusionsThe present data indicate that sublingual melatonin exerts well-defined dose-dependent antinociceptive activity. There is a correlation between the plasma melatonin drug concentration and acute changes in the pain threshold. These results provide additional support for the investigation of melatonin as an analgesic agent. Brazilian Clinical Trials Registry (ReBec): (U1111-1123-5109). IRB: Research Ethics Committee at the Hospital de Clínicas de Porto Alegre.

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Validation of a Brazilian quantitative sensory testing (QST) device for the diagnosis of small fiber neuropathies

Cited by 38 publications

References 28 publications

Test-retest studies in quantitative sensory testing: a critical review

Test-retest studies in quantitative sensory testing: a critical review

Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

A Phase II, Randomized, Double-Blind, Placebo Controlled, Dose-Response Trial of the Melatonin Effect on the Pain Threshold of Healthy Subjects

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