Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model

Ferland, Catherine; Villemure, Chantal; Michon, Pierre‐Emmanuel; Gandhi, Wiebke; Ma, My-Linh; Chouchou, Florian; Parent, Alexandre J.; Bushnell, M. Catherine; Lavigne, Gilles; Rainville, Pierre; Ware, Mark A.; Jackson, Philip L.; Schweinhardt, Petra; Marchand, S.

doi:10.1080/24740527.2018.1525682

Cited by 13 publications

(17 citation statements)

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“…A standardized QST protocol was administered. This protocol was inspired by the German Research Network on Neuropathic Pain 12 and the Quebec Pain Research Network 24 protocols regarding QST verbal instructions and technical handling. Four thermal parameters followed by five mechanical parameters were evaluated.…”

Section: Methodsmentioning

confidence: 99%

Classification of Qualitative Fieldnotes Collected During Quantitative Sensory Testing: A Step Towards the Development of a New Mixed Methods Approach in Pain Research

Bordeleau

Léonard

Gauthier

et al. 2021

JPR

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Purpose Quantitative sensory testing (QST) is a standardized method to assess somatosensory function. The collection of qualitative information, during the QST procedure, could be an interesting way to facilitate the characterization of altered sensory perception and the identification of different pain phenotypes. The aims of this study were 1) to classify qualitative fieldnotes of sensory abnormalities collected during an independent QST study, and 2) to generate a qualitative interview guide that could be included in the traditional QST procedure as a step towards the implementation of a mixed methods approach. Patients and Methods QST data were collected from 48 chronic neuropathic pain patients treated with spinal cord stimulation (SCS). Three body areas, with or without SCS, were tested: the painful limb targeted by SCS, the contralateral area, and the ipsilateral upper limb. After each trial of each QST modality, patients were encouraged to report any sensory abnormalities they could identify with a pain quality scale or using their own words. Results Qualitative self-reported sensory abnormalities were dichotomized into two groups: altered sensory intensities and altered sensory perceptions. Altered sensory intensities were classified as sensory loss or sensory gain subgroups. Altered sensory perceptions were classified as paresthesia and dysesthesia subgroups Overall, 630 qualitative fieldnotes of altered sensations were collected: 385 on the painful limb, 173 at the contralateral area, and 72 at the ipsilateral upper limb. Based on these qualitative data, we propose a standardized method to collect qualitative data involving 9 open- and close-ended questions and 21 codes. Conclusion Our findings have highlighted the value of qualitative sensory evaluation during QST and constitute an important milestone in the development of a mixed methods protocol in phenotyping research.

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Section: Methodsmentioning

confidence: 99%

Classification of Qualitative Fieldnotes Collected During Quantitative Sensory Testing: A Step Towards the Development of a New Mixed Methods Approach in Pain Research

Bordeleau

Léonard

Gauthier

et al. 2021

JPR

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“…For both experiments, 0.6 mL of a capsaicin 1% cream (CapsiGroup, Palmira, Colombia) were applied over a 3 × 3 cm area of skin surrounding the spinous process of the T5 vertebra. This capsaicin concentration has been used to produce tonic pain in previous studies (27,(49)(50)(51)(52)(53). Capsaicin was uniformly distributed and pressed against the skin by applying a piece of plastic wrap over the covered region.…”

Section: Capsaicin Painmentioning

confidence: 99%

Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals

et al. 2021

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Background and Aims: Spinal manipulation (SM) is currently recommended for the management of back pain. Experimental studies indicate that the hypoalgesic mechanisms of SM may rely on inhibition of segmental processes related to temporal summation of pain and, possibly, on central sensitization, although this remains unclear. The aim of this study was to determine whether experimental back pain, secondary hyperalgesia, and pain-related brain activity induced by capsaicin are decreased by segmental SM.Methods: Seventy-three healthy volunteers were randomly allocated to one of four experimental groups: SM at T5 vertebral level (segmental), SM at T9 vertebral level (heterosegmental), placebo intervention at T5 vertebral level, or no intervention. Topical capsaicin was applied to the area of T5 vertebra for 40 min. After 20 min, the interventions were administered. Pressure pain thresholds (PPTs) were assessed outside the area of capsaicin application at 0 and 40 min to examine secondary hyperalgesia. Capsaicin pain intensity and unpleasantness were reported every 4 min. Frontal high-gamma oscillations were also measured with electroencephalography.Results: Pain ratings and brain activity were not significantly different between groups over time (p > 0.5). However, PPTs were significantly decreased in the placebo and control groups (p < 0.01), indicative of secondary hyperalgesia, while no hyperalgesia was observed for groups receiving SM (p = 1.0). This effect was independent of expectations and greater than placebo for segmental (p < 0.01) but not heterosegmental SM (p = 1.0).Conclusions: These results indicate that segmental SM can prevent secondary hyperalgesia, independently of expectations. This has implications for the management of back pain, particularly when central sensitization is involved.

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“…At each assessment, sociodemographic and clinical information were collected or updated and a short QST protocol 39 and a physical functioning assessment were conducted. Self-report measures were completed before the first infusion (T0) and ≤7 days after T1.…”

Section: Methodsmentioning

confidence: 99%

“…Using an adapted protocol 39 we assessed cold (CPT) and heat pain threshold (HPT), and cool (CDT), warm (WDT), vibration (VDT; TSAII NeuroSensory Analyzer & VSA 3000, Medoc, Israel), and mechanical detection threshold (MDT; SenseLab Aesthesiometer II hand-held nylon filaments, Somedic, Sweden) on the dorsum of the right hand and foot 41,59 . A 3cm × 3cm thermode was used for thermal tests.…”

Section: Methodsmentioning

confidence: 99%

“…QST quantifies sensory nerve fiber functioning through tests of sensation and pain threshold to stimuli, like thermal, touch, and vibration. It can track sensory changes throughout treatment 17,18,39 , improve CIPN detection, and guide decision-making 7,40 . For example, cold allodynia and hyperalgesia in the hand predicts severe neuropathy 33 , people with CIPN have lower heat pain threshold than people without CIPN 34 , and moderate-to-severe CIPN is associated with reduced tactile and vibration perception in some studies 26 , but not others 35 .…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

Gauthier

Robichaud

Bouffard

et al. 2021

Preprint

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Purpose: In the absence of treatments for chemotherapy-induced peripheral neuropathy (CIPN), dose reductions (DR) and premature discontinuation (PD) are primary management strategies. However, decision-making guidance is insufficient and knowledge of factors associated with DRPD is limited. We examined biopsychosocial factors associated with CIPN-related DR/PD in women undergoing taxane-based chemotherapy for early-stage breast cancer. Patients and methods: As part of a longitudinal study of CIPN measurement, women completed assessments before the first taxane infusion and at the final infusion or within the originally expected timeframe for the final infusion. Participants completed self-report measures of CIPN, pain, and physical and psychosocial wellbeing, and underwent physical testing of lower limb disability and Quantitative Sensory Testing for sensation and pain threshold to thermal, vibration, and touch stimuli in the feet and hands. Sociodemographic and clinical data were collected. Logistic regression was used to identify factors associated with neuropathy-related DRPD. Results: Among 121 participants, 66 (54.5%) received taxane-as-prescribed, 46 (38.0%) had neuropathy-related DRPD, and 9 (7.4%) had DR/PD for other reasons. Factors associated with neuropathy-related DR/PD were receipt of paclitaxel (Odds Ratio [OR]=75.05, 95% Confidence Interval [CI] 2.56-2197.96]), lower pre-treatment pain catastrophizing (OR=0.72, 95% CI: 0.54-0.95), and higher post-treatment neuropathic pain (OR=10.77, 95% CI: 1.99-58.15) and sensitivity to cold pain in the hand (OR=1.64, 95% CI: 1.05-2.56). Conclusion: CIPN-related DRPD is associated with paclitaxel treatment and post-treatment neuropathic pain and cold pain sensitivity in the hands. CIPN communication to healthcare providers may be influenced by pain catastrophizing, suggesting symptom appraisal may be an important factor in communication. Findings could contribute to clinical practice recommendations to facilitate treatment decision-making.

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Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model

Abstract: Marchand (2018) Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model,

Cited by 13 publications

References 53 publications

Classification of Qualitative Fieldnotes Collected During Quantitative Sensory Testing: A Step Towards the Development of a New Mixed Methods Approach in Pain Research

Classification of Qualitative Fieldnotes Collected During Quantitative Sensory Testing: A Step Towards the Development of a New Mixed Methods Approach in Pain Research

Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals

Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

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