Development of a Novel Brief Quantitative Sensory Testing Protocol That Integrates Static and Dynamic Pain Assessments: Test-Retest Performance in Healthy Adults

Abstract

Objective Quantitative sensory testing is an expanding pain research domain with numerous clinical and research applications. There is a recognized need for brief reliable quantitative sensory testing protocols that enhance assessment feasibility. This study aimed to integrate static (pain threshold, tolerance, suprathreshold) and dynamic (conditioned pain modulation, offset analgesia, temporal summation) pain reactivity measures into a brief 20-minute protocol that uses a single portable device. The test-retest performance of this optimized protocol was evaluated. Design Using a test-retest design, the brief quantitative sensory testing assessment was administered to participants on two occasions separated by exactly 7 days. Setting A clinical psychology research laboratory at Syracuse University. Subjects Participants were 33 healthy adults recruited from Syracuse University’s online research participation pool. Methods A portable computerized quantitative sensory testing device delivered contact-heat pain to assess static and dynamic pain measures in participants. Dynamic responses were continuously recorded using a computerized visual analog scale. Results Pain threshold, tolerance, and suprathreshold exhibited excellent reliability (intraclass correlations ranged from 0.80 to 0.83). Conditioned pain modulation, offset analgesia, temporal summation yielded reliability in the good to excellent range (intraclass correlations ranged from 0.66 to 0.71). Conclusions Findings suggested that this brief integrated QST protocol may reliably monitor human pain reactivity over brief periods. This protocol may enhance quantitative sensory testing feasibility in clinical and research settings.

Conditioned pain modulation and offset analgesia: Influence of sex, sex hormone levels and menstrual cycle on the magnitude and retest reliability in healthy participants

“…These differences can at least partly be ascribed to using different protocols and more or less standardizable stimuli (Kennedy et al, 2016; Vaegter et al, 2018). Fewer studies have been conducted using offset analgesia as a paradigm (de Vita et al, 2022; Nilsson et al, 2014). While the ICC values we determined fall on the lower end of what has previously been reported, they follow similar patterns: the early CPM effect shows a higher degree of reliability compared to the late CPM effect, and the reliability of the initial stimulus is highest.…”

“…Since impaired descending pain modulation is discussed as a possible mechanism in the development of chronic pain (Arendt‐Nielsen et al, 2010; Staud et al, 2003) and in pain chronification (Grosen et al, 2014; Yarnitsky et al, 2008), reliable measures are important in distinguishing between normal fluctuation of subsequent measurements and measuring real progress of disease or treatment response. Reliability of offset analgesia (de Vita et al, 2022; Nilsson et al, 2014) and CPM has been studied with a variety of protocols (de Vita et al, 2022; Gehling et al, 2016; Kennedy et al, 2016; Kennedy et al, 2020; Özgül et al, 2017), and has been reported in many cases to be good to excellent, but also to be highly variable between studies (Kennedy et al, 2016; Vaegter et al, 2018). Influencing factors on CPM or offset effect could include sex and sex hormones, which have also been linked to differential pain perception (Aloisi, 2017; Bartley & Fillingim, 2013; Meyer‐Frießem et al, 2020; Racine et al, 2012), with a special focus on a possible anti‐nociceptive role of testosterone (White & Robinson, 2015).…”

Assessing Pain Research: A Narrative Review of Emerging Pain Methods, Their Technosocial Implications, and Opportunities for Multidisciplinary Approaches

“…Until recently, many PROs have been implemented cross-sectionally, at clinic or research visits, occurring every few weeks to months or more infrequently on the order of years. Their administration has also largely been limited to written or verbal responses (e.g., completing questions on a physical form or answering aloud in front of a staff member); this might happen once during a visit or several times in succession as part of provoked pain paradigms, psychophysics experiments, or quantitative sensory testing ( 27 – 29 ). This infrequent in-person approach might make sense for specific pain conditions or highly-controlled research questions but does not easily measure pain fluctuations ( 30 ) or pain perturbation by environmental, psychological, or socioeconomic factors ( 31 – 34 ).…”

Evidence for alterations to dynamic quantitative sensory tests in patients with chronic temporomandibular myalgia: A systematic review of observational studies with meta‐analysis

“…Based on the existing literature, we have considered quantitative sensory tests as dynamic if they evaluated changes in pain ratings or thresholds related to the integration by the nervous system of multiple stimuli 11,13,21,22 …”

“…Based on the existing literature, we have considered quantitative sensory tests as dynamic if they evaluated changes in pain ratings or thresholds related to the integration by the nervous system of multiple stimuli. 11,13,21,22 We excluded studies where TMDm was associated with nonmusculoskeletal orofacial disorders (e.g. trigeminal neuralgia), neuropathic pain, cancer-related pain, recent (<6 months) orthodontic/ dental intervention or surgery.…”