Thermal quantitative sensory testing in healthy Dutch children and adolescents standardized test paradigm and Dutch reference values

Abstract

BackgroundQuantitative sensory testing (QST) is often used to measure children’s and adults’ detection- and pain thresholds in a quantitative manner. In children especially the Thermal Sensory Analyzer (TSA-II) is often applied to determine thermal detection and pain thresholds. As comparisons between studies are hampered by the different testing protocols used, we aimed to present a standard protocol and reference values for thermal detection- and pain thresholds in children.MethodsOur standard testing protocol includes reaction time dependent and independent tests and takes about 14–18 min to complete. Reference values were obtained from a sample of 69 healthy term born children and adolescents with a median age of 11.2 years (range 8.2 to 17.9 years old). Seventy-one children were recruited and data of 28 males and 41 females was obtained correctly. We studied possible age and sex differences.ResultsThis study provides Dutch reference values and presents a standard quantitative sensory testing protocol for children with an age from 8 years onwards. This protocol appeared to be feasible, since only two out of 71 participants were not able to correctly complete the protocol due to attention deficits and were therefore excluded. We found some significant age and sex differences: females were statistically significantly more sensitive for both cold and heat pain compared to males, and the youngest children (8–9 years old) were less sensitive to detect a warm stimulus. The youngest children tend to be more sensitive to heat pain in comparison to older participants, although the difference was not statistically significant.ConclusionsWe present a feasible thermal quantitative sensory testing protocol for children and reference values that are easy to interpret and may serve as normative values for future studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0827-7) contains supplementary material, which is available to authorized users.

Sensory Function and Psychological Factors in Children With Complex Regional Pain Syndrome Type 1

“…Mean cold and warm thresholds on the volar distal forearm were 30.5°C and 33.7°C, respectively, for the children, 8-9 years old, and 31.2°C and 33.1°, respectively for the adolescents, 14-17 years old. 34 In turn, these previously reported values are comparable to the threshold data obtained in the current study from the nonaffected dominant forearm in children with CRPS-I. Additionally no differences in dominant-arm thermal threshold data was evident between the patients and controls.…”

Method-of-limits; Cold and warm perception thresholds at proximal and distal body regions

“…Although there are several reports on normative values for QST, both from single centre as well as from multi-centre studies, there is yet no comprehensive study describing full normative data for multiple body regions derived from the same group of healthy subjects. Previously reported reference data mostly assess distal sites in the lower and upper extremities ( Blankenburg et al, 2010 , González-Duarte et al, 2016 , Hafner et al, 2015 , Lin et al, 2005 , Malmström et al, 2016 , Magerl et al, 2010 , Meier et al, 2001 , Rolke et al, 2006 , van den Bosch et al, 2017 , Yarnitsky and Sprecher, 1994 ), although some of the studies also include the face ( Blankenburg et al, 2010 , Magerl et al, 2010 , Rolke et al, 2006 ).…”

Current View of Diagnosing Small Fiber Neuropathy

“…With the method of levels, 2 buttons are available representing yes or no. For each stimulus, the question is asked whether the thermode becomes colder or not [ 74 ]. With the method of levels, only thermal detection thresholds are determined and no thermal pain thresholds.…”