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Quantitative sensory testing: a comprehensive protocol for clinical trials.

R Rolke1, W Magerl, K Andrews Campbell

  • 1Institute of Physiology and Pathophysiology, Johannes Gutenberg-University, Saarstr. 21, D-55099 Mainz, Germany.

European Journal of Pain (London, England)
|November 18, 2005
PubMed
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This study developed a comprehensive Quantitative Sensory Testing (QST) protocol to assess somatosensory function, identifying sensory loss or gain patterns in neuropathic pain. The protocol efficiently profiles sensory function within an hour for clinical characterization.

Area of Science:

  • Neurology
  • Pain Medicine
  • Neuroscience

Background:

  • Quantitative Sensory Testing (QST) is crucial for diagnosing neuropathic pain.
  • Standardized protocols are needed to assess somatosensory function comprehensively.
  • Existing methods may not cover all sensory modalities or pain types.

Purpose of the Study:

  • To develop and validate a comprehensive QST protocol for the German Research Network on Neuropathic Pain (DFNS).
  • To assess thermal and mechanical sensory perception, including small and large nerve fiber functions.
  • To evaluate patterns of sensory loss or gain and deep pain sensitivity.

Main Methods:

  • A standardized QST protocol was applied to 18 healthy subjects (21-58 years) bilaterally across face, hand, and foot.

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  • Included thermal detection/pain thresholds, mechanical detection/pain thresholds, allodynia, and pain summation (wind-up ratio).
  • Protocol duration was approximately 27 minutes per test area.

    • Main Results:

    • Most QST parameters required logarithmic transformation for normal distribution.
    • Sensory thresholds varied by body region (face < hand < foot), except for thermal pain, wind-up, and vibration.
    • High left-to-right correlation (0.78-0.97) indicated protocol reliability.

    Conclusions:

    • The developed QST protocol provides a comprehensive somatosensory profile within one hour.
    • It is valuable for characterizing patients with various diseases by comparing affected and unaffected areas.
    • Z-transformed QST data facilitate easy survey of individual symptom profiles.