Quantitative sensory testing in measurement of neuropathic pain phenomena and other sensory abnormalities

Miroslav Misha Backonja, David Walk, Robert R. Edwards, Nalini Sehgal, Toby Moeller-Bertram, Ajay Wasan, Gordon Irving, Charles Argoff, Mark Wallace

Research output: Contribution to journalReview articlepeer-review

113 Scopus citations

Abstract

Neuropathic pain disorders are usually characterized by spontaneous ongoing or intermittent symptoms, stimulus-evoked positive sensory phenomena, and negative sensory phenomena. Spontaneous individual subject specific phenomena are identified in the neurologic history and are quantifiable by means of self-reported neuropathic pain symptoms tools such as scales, inventories, and questionnaires. Negative and positive sensory phenomena are assessed by the neurologic bedside examination and quantitative sensory testing (QST), which refers to psychophysical tests of sensory perception during the administration of stimuli with predetermined physical properties and following specific protocols. QST is able to capture and quantify stimulusevoked negative and positive sensory phenomena, and as such should become standard if not a critical tool in neuropathic pain research and practice. Although the advent of anatomic and functional imaging modalities is revolutionizing our understanding of the mechanisms of neuropathic pain, only by anchoring such test results to individual subjects' own perceptions via QST can they provide meaningful information about neuropathic pain, which is based on perceptual experience. To yield useful results, QST requires a cooperative subject and carefully standardized methods, including standardization of the stimulus parameters as well as the testing environment, instructions, and evaluation methods. This manuscript provides a concise review of fundamental concepts necessary for understanding the role of QST in the process of eliciting information about sensory abnormalities associated with neuropathic pain and the place of that information in analysis of pain mechanisms. Together with the companion manuscript, this review provides definitions that should help further the use of QST as a diagnostic tool as well.

Original languageEnglish (US)
Pages (from-to)641-647
Number of pages7
JournalClinical Journal of Pain
Volume25
Issue number7
DOIs
StatePublished - Sep 2009

Keywords

  • Allodynia
  • Hyperalgesia
  • Neuropathic pain
  • Pain testing
  • QST
  • Quantitative sensory testing

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