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Test-Retest Reliability of Perception Threshold Estimation in Small Cutaneous Nerve Fibers: A Methodological
Helena Brøckner1, Sarah Nygaard Jensen1, Kristian Hennings1
1Health Science and Technology, Aalborg University, Aalborg, Denmark.
Muscle & Nerve
|September 22, 2025
Summary
Perception threshold (PT) tracking using the Psi method and Method of Limits (MoL) shows reliable test-retest results, particularly within a single session. However, PT values differ between these nerve excitability testing algorithms.
Area of Science:
- Neuroscience
- Clinical Electrophysiology
Background:
- Small fiber neuropathy diagnosis requires understanding small cutaneous nerve fiber function.
- Nerve excitability testing offers a novel approach to investigate these mechanisms.
- Perception threshold (PT) tracking using pin-electrodes is a key technique.
Purpose of the Study:
- To compare the test-retest reliability of two PT algorithms: the Psi method and the Method of Limits (MoL).
- To evaluate the suitability of these methods for nerve excitability testing.
Main Methods:
- Twenty healthy subjects participated in the study.
- Electrical stimulation with a 1 ms pulse was applied via a pin electrode.
- PT was measured six times across two sessions one week apart, analyzed using ICC and CV.
Main Results:
- Both Psi and MoL methods demonstrated good within-session reliability (ICC > 0.77).
- Between-session reliability was lower for both methods (ICC < 0.58).
- MoL yielded significantly lower PT estimates (0.88 mA) compared to the Psi method (1.12 mA).
Conclusions:
- PT estimation is reliable, especially within-session, using both MoL and Psi methods.
- PT tracking provides insights into nerve fiber excitability.
- PT values are method-dependent and not directly interchangeable between Psi and MoL.
