Responsiveness of quantitative sensory testing-derived sensory phenotype to disease-modifying intervention in patients with entrapment neuropathy: a longitudinal study

Abstract

D.M Methods using N-(2propenyl) hexadecanamide and related amides to relieve pain. WO 2005/079771, Okuse K. et al Methods of treating pain by inhibition of vgf activity EP13702262.0/ WO2013 110945

Pain mechanisms in carpal tunnel syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes

“…In the hand median nerve territories, including index finger, middle finger, and thenar area, the meta-analysis of 9 studies of 531 patients with CTS showed a significant loss of mechanical detection sensation in the CTS group (SMD, 1.04; 95% CI, 0.57, 1.52; P < 0.001), with considerable heterogeneity (I 2 = 87%; P < 0.001) 5,6,47,61,63,77,91,95,103 (Fig. 5A).…”

“…The meta-analysis of 14 studies of CTS in the hand median nerve territories (index and middle fingers, carpal area, and thenar area) reported no difference in HPT (SMD, −0.22; 95% CI, −0.51, 0.06; P = 0.123), with substantial heterogeneity (I 2 = 81%; P < 0.001) 5,6,9,15,16,40,47,53,56,61,79,82,91,111 (Fig. 8A).…”

“…26,82,111 There was also a difference in intensity of electrodiagnostic findings of CTS, ranging from mild to severe, and 2 recent studies showed signs of thermal and mechanical hyperalgesia in moderate-to-severe cases of CTS compared with mild. 47,61 Of importance, only the studies of Fern ández-De-Las-Pen ˜as et al reported the presence of thermal and mechanical hyperalgesia with no evidence of sensory loss, 15,26 which could be explained by the presence of associated neck pain potentially magnifying the results of PPT, HPT, CPT, and MPT in the CTS group. 81 Furthermore, symptom heterogeneity (pain-dominant CTS vs paresthesiadominant CTS) could play a role in the heterogeneity of HPT, CPT, and PPT because a recent study showed that a different pattern of changes occurred in sensory and motor cortices based on dominant symptoms.…”

“…Finally, the results of our review are based on group level, not individual level, but QST results based on individual level (z scores) were mentioned in 3 studies by Kennedy et al, Tampin et al, and Matesanz et al, showing dominant sensory loss (22%, 24%, and 33%, respectively) with heterogenous percentages of thermal hyperalgesia (1%, 20%, and 45%, respectively) and mechanical hyperalgesia (36%, 20%, and 45%, respectively). 47,61,91 The most convincing indicator of CS in CTS was impaired descending pain inhibition. 46,85 Two main approaches can assess descending pain inhibition in chronic pain conditions: offset analgesia (OA) as a temporal indicator and CPM as a spatial one.…”

“…2) and no significant publication bias (P 5 0.186). 5,6,[14][15][16]32,40,47,53,56,61,82,89,91,95 The meta-analysis of 4 studies that investigated CDT in 258 patients with CTS in extraterritorial hand areas (ie, little finger and dorsum of the hand) showed significant loss of cold detection sensation 32,40,56,61 (SMD, 20.55; 95% CI, 20.75 to 20.35; P , 0.001), with no heterogeneity (I 2 5 0%; P 5 0.639) (Supplementary Figure 1, available as supplemental digital content at http:// links.lww.com/PAIN/B555).…”