| Test order of quantitative sensory testing facilitates mechanical hyperalgesia in healthy volunteers. | |
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MedLine Citation:
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PMID: 22208803 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Quantitative sensory testing (QST) has become a widely used method to evaluate different submodalities of the somatic sensory system (predominantly) in patients with neuropathic pain. QST consists of 7 tests measuring 13 parameters in order to assess and quantify the perception of temperature, touch, pain, pressure, and vibration. The German Research Network on Neuropathic Pain implemented a standardized QST protocol including a defined testing order of the measurements. Accordingly, subjects tested with QST undergo thermal before mechanical testing. In the present study, we investigated the effect of testing order on the results of QST. Twenty healthy subjects were tested twice, 1 week apart with 2 different QST testing orders: the standardized testing order according to the German Research Network on Neuropathic Pain and a modified testing order in which mechanical stimuli were applied before thermal stimuli. For the test protocol that began with thermal testing, subjects exhibited signs of an increased mechanical perception: The mechanical pain sensitivity was significantly increased (P = .001, Wilcoxon test) for each pinprick stimulator and the mechanical pain threshold was lowered by a factor of 2 when compared with the modified testing order in which mechanical parameters were tested at the beginning of the session without prior thermal stimulation. Thermal parameters were the same for both test-order paradigms. These data indicate that preceding mild thermal stimulation might lead to a sensitization to mechanical stimuli and thus to mechanical hyperalgesia. Alternative habituation mechanisms in the modified testing order resulting from repeated pinprick stimulation at the beginning should also be debated. QST is a helpful diagnostic tool but interpretation should be done with consideration of interaction between test parameters. Reference data are only valid in the testing order from which they are obtained. PERSPECTIVE: Present data showed that mechanical hyperalgesia followed thermal testing. This article demonstrates that the test order of quantitative sensory testing is relevant in interpreting the results obtained. Reference values are suitable in the test order from which they are obtained. |
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Authors:
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Eva Gröne; Alexander Crispin; Johannes Fleckenstein; Dominik Irnich; Rolf-Detlef Treede; Philip M Lang |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The journal of pain : official journal of the American Pain Society Volume: 13 ISSN: 1528-8447 ISO Abbreviation: J Pain Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100898657 Medline TA: J Pain Country: United States |
Other Details:
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Languages: eng Pagination: 73-80 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Anaesthesiology, University of Munich, Munich, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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