医学
接收机工作特性
定量感官测试
痛阈
颈部疼痛
感觉阈
无症状的
转移性疼痛
总和
物理疗法
感觉系统
麻醉
痛觉减退
慢性疼痛
刺激
物理医学与康复
外科
伤害
痛觉过敏
内科学
病理
受体
认知心理学
认知科学
替代医学
心理学
作者
Alban Y. Neziri,Andreas Limacher,Peter Jüni,Bogdan P. Radanov,Ole Kæseler Andersen,Lars Arendt‐Nielsen,Michele Curatolo
出处
期刊:Regional Anesthesia and Pain Medicine
[BMJ]
日期:2013-01-01
卷期号:38 (4): 308-320
被引量:29
标识
DOI:10.1097/aap.0b013e318295a3ea
摘要
Background and Objectives
Quantitative sensory testing (QST) is widely used to investigate peripheral and central sensitization. However, the comparative performance of different QST for diagnostic or prognostic purposes is unclear. We explored the discriminative ability of different quantitative sensory tests in distinguishing between patients with chronic neck pain and pain-free control subjects and ranked these tests according to the extent of their association with pain hypersensitivity. Methods
We performed a case-control study in 40 patients and 300 control subjects. Twenty-six tests, including different modalities of pressure, heat, cold, and electrical stimulation, were used. As measures of discrimination, we estimated receiver operating characteristic curves and likelihood ratios. Results
The following quantitative sensory tests displayed the best discriminative value: (1) pressure pain threshold at the site of the most severe neck pain (fitted area under the receiver operating characteristic curve, 0.92), (2) reflex threshold to single electrical stimulation (0.90), (3) pain threshold to single electrical stimulation (0.89), (4) pain threshold to repeated electrical stimulation (0.87), and (5) pressure pain tolerance threshold at the site of the most severe neck pain (0.86). Only the first 3 could be used for both ruling in and out pain hypersensitivity. Conclusions
Pressure stimulation at the site of the most severe pain and parameters of electrical stimulation were the most appropriate QST to distinguish between patients with chronic neck pain and asymptomatic control subjects. These findings may be used to select the tests in future diagnostic and longitudinal prognostic studies on patients with neck pain and to optimize the assessment of localized and spreading sensitization in chronic pain patients.
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