Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing

Mackey, Ian; Dixon, E.; Johnson, Kevin; Kong, Jiang-Ti

doi:10.3791/54452-v

Cited by 8 publications

(15 citation statements)

References 19 publications

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“…Static measures of pressure pain threshold, specifically mechanical, were most widely used as a marker of sensory sensitivity regardless of clinical population examined. These results demonstrate that static QST is most widely used to examine physical activity neuromodulation, despite other work citing dynamic QST as the more appropriate indirect assessment of neuromodulation 13 . Researchers may preferentially incorporate mechanical pressure pain QST metrics due to testing tool availability, ease of application, and low associated costs (e.g., Semmes-Weinstein filaments and pressure algometry) as compared with thermal and vibratory measures.…”

Section: Discussionmentioning

confidence: 94%

“…These results demonstrate that static QST is most widely used to examine physical activity neuromodulation, despite other work citing dynamic QST as the more appropriate indirect assessment of neuromodulation. 13 Researchers may preferentially incorporate mechanical pressure pain QST metrics due to testing tool availability, ease of application, and low associated costs (e.g., Semmes-Weinstein filaments and pressure algometry) as compared with thermal and vibratory measures. An additional reason may be mechanical pain pressure threshold (PPT) demonstration of high interrater and intrarater reliability.…”

Section: Discussionmentioning

confidence: 99%

“…For example, psychophysical responses to repeated painful stimuli (i.e., temporal summation) is an indirect assessment of central pain facilitation. 13 Meanwhile, a reduction in pain or increase in pain threshold after a conditioning pain stimulus, referred to as conditioned pain modulation, is in indirect assessment of descending inhibitory processing. 7,8 The QST devices vary from simple hand-held tools like Semmes-Weinstein filaments or algometers to complex, computerized equipment.…”

mentioning

confidence: 99%

“…Quantitative sensory testing is also used to specifically provide a window into the central nervous system processing of painful stimuli, sometimes referred to as “dynamic QST.” For example, psychophysical responses to repeated painful stimuli (i.e., temporal summation) is an indirect assessment of central pain facilitation 13 . Meanwhile, a reduction in pain or increase in pain threshold after a conditioning pain stimulus, referred to as conditioned pain modulation, is in indirect assessment of descending inhibitory processing 7,8 .…”

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confidence: 99%

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Quantitative Sensory Changes Related to Physical Activity in Adult Populations

Baehr

Law

Finley

2021

Am J Phys Med Rehabil

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Exercise-induced hypoalgesia related to physical activity produces sensory adaptations, but its mechanism remains unclear. Quantitative sensory testing is an effective measurement tool to identify sensory changes, but the extent of evidence linking quantitative sensory testing and physical activity has not been explored. The purpose of this scoping review is to synthesize the evidence on using quantitative sensory testing to evaluate psychophysical changes related to physical activity in adult populations. The researchers developed a comprehensive search strategy with a Health Sciences Librarian using the Arksey and O'Malley Methodological framework. Four databases (Medline [PubMed], CINAHL, Web of Science, and Embase) were searched for peer-reviewed primary research. After 2790 articles were evaluated, 196 studies were included for final review. More than half of studies used randomized controlled trial design (50.5%), followed by quasi-experimental (24.0%) and observational (25.5%) strategies. Healthy adults (42.9%) and individuals with chronic health conditions (20.9%) were examined most frequently. Aerobic (27.6%) and strength (21.4%) physical activity types were most commonly studied. Static quantitative sensory testing measures of pressure pain threshold (84%) were used most frequently. The findings of this scoping review demonstrate available evidence for quantitative sensory testing as a measurement tool of neuromodulation related to physical activity in adult populations. A systematic review is warranted to examine outcomes and recommendations.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Quantitative Sensory Changes Related to Physical Activity in Adult Populations

Baehr

Law

Finley

2021

Am J Phys Med Rehabil

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“…On the other hand, dynamic tests include the contribution of at least 2 stimuli assessing the function of descending pain pathways or pain wind up[ 31 ]. Dynamic tests are predictive of the development of CS mechanisms[ 32 ]. The prognostic ability of QST has also been studied in individuals with chronic musculoskeletal pain[ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of quantitative sensory testing focusing on healthy and patients with shoulder pain: a systematic review protocol

et al. 2021

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Background: Quantitative sensory testing (QST) is a battery of non-invasive psychophysical methods to assess the function of somatosensory system. Although the use of QST is widespread and several studies in patients with chronic shoulder pain have used it, the level of evidence for the psychometric properties has not been established. The aim of this protocol is to investigate, through a systematic review, the level of evidence for the psychometric properties of QST in the shoulder.Methods: For conducting and reporting this review the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines will be used. Nine databases including PubMed, Medline, AMED (via EBSCO), PEDRO, Embase, Web of Science, Scopus, SportDiscus, Google Scholar and Cochrane Library will be searched for the period from their inception until September 2021. Two reviewers (BP and SK) will independently evaluate the retrieved articles (titles and abstracts) and the psychometric characteristics checklist based on the standards from the COSMIN. The modified grading of recommendations assessment, development, and evaluation (GRADE) approach will be used to assess the overall quality of the evidence.Conclusions: Evaluation of the level of evidence for the psychometric properties of QST in the shoulder is an essential step for evidence-based assessment in clinical practice.Trial registration: PROSPERO registration number is CRD42021232778.

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Association between temporal summation and conditioned pain modulation in chronic low back pain: baseline results from 2 clinical trials

Kong

You

Law

et al. 2021

PR9

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Introduction: Temporal summation (TS) and conditioned pain modulation (CPM) represent different aspects of central pain processing. Their relationship and differential performance within distinct body locations are not well understood. Objectives: To examine the association between TS and CPM in chronic low back pain and the influence of testing location on this relationship. Methods: We analyzed baseline data from 2 clinical trials on participants with chronic low back pain (n 5 264; 47.3% female; mean age 5 41 years, SD 5 12; mean pain 5 5.3/10, SD 5 1.4). Measures used included questionnaires assessing pain and negative affect, phasic thermal TS at the hand (thenar) and the lower back (lumbar), followed by CPM that included a thermal testing stimulus (Heat-6, the temperature where pain rating is 6/10) and a cold-pressor conditioning stimulus. Nonparametric, proportional odds logistic regression was used to model thenar, and separately, lumbar TS, using CPM, Heat-6, negative affect, and demographics. Results: Our models revealed a small association (bs 5 0.17, P 5 0.01) between reduced CPM and heightened TS at both testing sites, regardless of demographics or negative affect. Conclusion: Results suggest a modest association between TS and CPM, irrespective of anatomical testing location, demographics, and negative affect. These findings will help improve the methodology and interpretation of TS and CPM measurement in clinical pain populations.

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Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing

Cited by 8 publications

References 19 publications

Quantitative Sensory Changes Related to Physical Activity in Adult Populations

Quantitative Sensory Changes Related to Physical Activity in Adult Populations

Psychometric properties of quantitative sensory testing focusing on healthy and patients with shoulder pain: a systematic review protocol

Association between temporal summation and conditioned pain modulation in chronic low back pain: baseline results from 2 clinical trials

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