NeuroQuick--a novel bedside test for small fiber neuropathy?

Area of Science:

• Neurology
• Medical Devices
• Pain Management

Background:

• Small fiber neuropathy diagnosis lacks an appropriate bedside test.
• Cold hypaesthesia is an early symptom of small fiber neuropathy.
• The NeuroQuick (NQ) device was proposed for quantitative assessment of cold perception.

Purpose of the Study:

• To compare the NeuroQuick (NQ) device with quantitative sensory testing (QST).
• To evaluate NQ's performance in patients with chronic painful dysesthesia.
• To assess NQ's accuracy in detecting pathological cold detection thresholds (CDT).

Main Methods:

• Forty-one patients with chronic painful dysesthesia were enrolled.
• Quantitative sensory testing (QST) was performed per German network protocol.
• The NeuroQuick device was used for bedside quantitative cold thermal perception testing.

Main Results:

• The NeuroQuick showed 7.4% false positives and 50% false negatives for cold hypaesthesia.
• NQ demonstrated 92.6% specificity but only 50% sensitivity.
• Positive and negative predictive values for NQ were 78%.

Conclusions:

• The NeuroQuick is inadequate as a screening device for cold hypaesthesia in neuropathic pain.
• The device exhibits high specificity but insufficient sensitivity for small fiber dysfunction.
• A reliable screening tool requires both high sensitivity and specificity.