Quantitative Sensory Testing (QST) - Does assessing ... - TI Pharma
Quantitative Sensory Testing (QST) - Does assessing ... - TI Pharma
Quantitative Sensory Testing (QST) - Does assessing ... - TI Pharma
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2. Bilateral abnormalities in neuropathic pain<br />
patients with unilateral pain. Additional studies are needed to evaluate for instance if<br />
the severity of pain determines the onset of contralateral changes and if ongoing pain<br />
is the driving force for the maintenance of contralateral abnormalities in chronic pain<br />
patients.<br />
4.4. Correlation between sensory changes at affected and contralateral side<br />
An interesting finding is that the presence of sensory gain or loss at the affected side<br />
was related to sensory gain or loss for the same <strong>QST</strong> parameter at the contralateral<br />
side, ranging from 25% to 58% dependent on the <strong>QST</strong> parameter. In particular for the<br />
group of mechanical stimuli the estimated presence of sensory abnormalities at the nonaffected<br />
side was substantial (ranging from 35%-52%). Although sensory abnormalities<br />
at the contralateral side were less pronounced compared to those at the affected side,<br />
there was a significant correlation between the numbers of sensory abnormalities at both<br />
sides in patients.<br />
Contrary to recommendations to use the contralateral side as a reference to identify<br />
sensory abnormalities in patients (Haanpaa et al 2010; Haanpaa et al 2009) our data<br />
indicate that this is not advisable since the sensory function at the contralateral side<br />
stands a reasonable chance to be altered. The interpretation of sensory signs and its<br />
clinical manifestations using the contralateral side or reference values from healthy<br />
subjects may vary (see Table 2-4 for examples).<br />
Table 2-4: Diagnostic consequence of using either the contralateral side or normative data from healthy volunteers.<br />
The difference between the last two columns shows that the choice of reference is not trivial and that using the contralateral<br />
side in the same patient can lead to misinterpretation of sensory function.<br />
observation<br />
affected side<br />
0<br />
+ -00<br />
+<br />
+ --<br />
observation<br />
contralateral side<br />
0<br />
0<br />
0<br />
+ -<br />
+ -<br />
+ -<br />
clinical result using<br />
contralateral side as<br />
reference<br />
clinical result using<br />
healthy volunteers as<br />
reference<br />
The interpretation of sensory function and its clinical manifestation at the affected side using the<br />
contralateral side or reference values from healthy subjects. The observation at the affected side<br />
and contralateral side indicate the sensory response for a <strong>Quantitative</strong> <strong>Sensory</strong> <strong>Testing</strong> (<strong>QST</strong>)<br />
parameter in patients. Clinical results using the contralateral side as reference or healthy volunteers<br />
as reference indicate sensory interpretation for the affected side. ‘0’ indicate normal sensory function,<br />
‘+’ indicate sensory gain such as hyperalgesia/allodynia, ‘-‘ indicate sensory loss such as hypesthesia,<br />
‘++’ or ‘- -‘ indicate overestimation of sensory gain or sensory loss, respectively.<br />
0<br />
+ --<br />
+ 0<br />
++<br />
--0<br />
0<br />
+ -00<br />
+<br />
+ --