Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Reference data for the trunk and application in patients with chronic postherpetic neuralgia

Pfau, Doreen B.a,*,1; Krumova, Elena K.b,1; Treede, Rolf-Detlefa,2; Baron, Ralfc,2; Toelle, Thomasd,2; Birklein, Franke; Eich, Wolfgangf; Geber, Christiane; Gerhardt, Andreasf; Weiss, Thomasg; Magerl, Waltera; Maier, Christophh,2

doi: 10.1016/j.pain.2014.02.004
Articles
Buy

Summary A new set of reference data on the trunk for male and female healthy subjects is presented and applied to patients with postherpetic neuralgia.

ABSTRACT Age- and gender-matched reference values are essential for the clinical use of quantitative sensory testing (QST). To extend the standard test sites for QST—according to the German Research Network on Neuropathic Pain—to the trunk, we collected QST profiles on the back in 162 healthy subjects. Sensory profiles for standard test sites were within normal interlaboratory differences. QST revealed lower sensitivity on the upper back than the hand, and higher sensitivity on the lower back than the foot, but no systematic differences between these trunk sites. Age effects were significant for most parameters. Females exhibited lower pressure pain thresholds (PPT) than males, which was the only significant gender difference. Values outside the 95% confidence interval of healthy subjects (considered abnormal) required temperature changes of >3.3–8.2 °C for thermal detection. For cold pain thresholds, confidence intervals extended mostly beyond safety cutoffs, hence only relative reference data (left-right differences, hand-trunk differences) were sufficiently sensitive. For mechanical detection and pain thresholds, left-right differences were 1.5–2.3 times more sensitive than absolute reference data. The most sensitive parameter was PPT, where already side-to-side differences >35% were abnormal. Compared to trunk reference data, patients with postherpetic neuralgia exhibited thermal and tactile deficits and dynamic mechanical allodynia, mostly without reduced mechanical pain thresholds. This pattern deviates from other types of neuropathic pain. QST reference data for the trunk will also be useful for patients with postthoracotomy pain or chronic back pain.

aDepartment of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

bDepartment of Neurology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr University Bochum, Bochum, Germany

cDivision of Neurological Pain Research and Therapy, Department of Neurology, Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Germany

dDepartment of Neurology, Technische Universität, München, Germany

eDepartment of Neurology, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany

fDepartment of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany

gDepartment of Biological and Clinical Psychology, Institute of Psychology, Friedrich Schiller University, Jena, Germany

hDepartment of Pain Medicine, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH Bochum, Ruhr University Bochum, Bochum, Germany

* Corresponding author. Address: Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, Mannheim 68167, Germany. Tel.: +49 621 383 9926.

E-mail address:doreen.pfau@medma.uni-heidelberg.de

1 These authors contributed equally to this study.

2 DFNS steering committee.

Article history:

Received 11 September 2013

Received in revised form 31 December 2013

Accepted 5 February 2014

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2014 International Association for the Study of Pain
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website