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The role of quantitative sensory testing in the prediction of chronic pain

Treede, Rolf-Detlef

doi: 10.1097/j.pain.0000000000001544
NeuPSIG Closing Debate

Quantitative sensory testing (QST) is a formal variant of a time-honoured clinical examination technique in neurology, the sensory examination. Prototypical QST profiles have been found in human surrogate models of peripheral sensitization, central sensitization, and deafferentation. Probabilistic sorting of individual patients to any combination of these profiles has been developed, and there is emerging evidence for the predictive value of such sensory profiles for treatment efficacy. This way, QST aids in diagnostics of individual patients and may help guide their care in the future. Deficits in “dynamic” QST have been proposed as predictors of chronic pain (impaired descending inhibition and delayed recovery from central sensitization). Several psychological factors had previously been found to be predictors of pain chronicity (catastrophizing, self-efficacy, and neuroticism). The relative importance of psychological vs sensory testing predictors has not been evaluated. It is likely that both will have differential roles in clinical practice.

Quantitative sensory testing can predict propensity to develop chronic pain, differential sensitivity to treatment effects, and potential underlying mechanisms of neuropathic pain at the individual patient level. This makes it a powerful clinical technique for future personalized pain management as well as for the development of new treatment approaches.

Department of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Heidelberg University, Mannheim, Germany

Corresponding author. Address: Department of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Heidelberg University, Ludolf-Krehl-Str 13-17, 68167 Mannheim, Germany. Tel.: +49 621 383 71400; fax: +49 621 383 71401. E-mail address: (R.-D. Treede).

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

Received February 12, 2019

Received in revised form February 21, 2019

Accepted February 25, 2019

© 2019 International Association for the Study of Pain
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