The responsiveness of quantitative sensory testing-derived sensory phenotype to disease-modifying intervention in patients with entrapment neuropathy: a longitudinal study
File(s)
Author(s)
Kennedy, Donna L
Vollert, Jan
Ridout, Deborah
Alexander, Caroline M
Rice, Andrew Sc
Type
Journal Article
Abstract
ABSTRACT: The German Research Network on Neuropathic Pain (DFNS) quantitative sensory testing (QST) method for sensory phenotyping is used to stratify patients by mechanism associated sensory phenotype, theorised to be predictive of intervention efficacy. We hypothesised that change in pain and sensory dysfunction would relate to change in sensory phenotype. We investigated the responsiveness of sensory phenotype to surgery in patients with an entrapment neuropathy.With ethical approval and consent, this observational study recruited patients with neurophysiologically confirmed carpal tunnel syndrome. Symptom and pain severity parameters and DFNS QST were evaluated prior to and after carpal tunnel surgery. Surgical outcome was evaluated by patient-rated change. Symptom severity score of the Boston Carpal Tunnel Questionnaire and associated pain and paraesthesia subgroups were comparators for clinically relevant change.QST results (n=76) were compared to healthy controls (n=54). At 6 months post-surgery 92% participants reported a good surgical outcome and large decrease in pain and symptom severity (p<.001). Change in QST parameters occurred for thermal detection, thermal pain and mechanical detection thresholds with a moderate to large effect size. Change in mechanical pain measures were not statistically significant. Change occurred in sensory phenotype post-surgery (p<.001); sensory phenotype was associated with symptom subgroup (p=.03) and patient-rated surgical outcome (p =.02).QST derived sensory phenotype is sensitive to clinically important change. In an entrapment neuropathy model, sensory phenotype was associated with patient-reported symptoms and demonstrated statistically significant, clinically relevant change after disease modifying intervention. Sensory phenotype was independent of disease severity and may reflect underlying neuropathophysiology.
Date Issued
2021-12
Date Acceptance
2021-03-19
Citation
Pain, 2021, 162 (12), pp.2881-2893
ISSN
0304-3959
Publisher
Elsevier
Start Page
2881
End Page
2893
Journal / Book Title
Pain
Volume
162
Issue
12
Copyright Statement
© 2021 by the International Association for the Study of Pain. Unauthorized reproduction of this article is prohibited. This is a non-final version of an article published in final form in PAIN, 22 March 2021, https://doi.org/10.1097/j.pain.0000000000002277
Sponsor
Health Education England (HEE)
NIHR Imperial Biomedical Research Centre
National Institute for Health Research (NIHR)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33769367
PII: 00006396-900000000-98083
Grant Number
CDRF-2013-04-009
RFPoD1920/103
CDRF 2013-04-009
Subjects
Science & Technology
Life Sciences & Biomedicine
Anesthesiology
Clinical Neurology
Neurosciences
Neurosciences & Neurology
QST
sensory phenotype
neuropathic pain
responsiveness
stratification
CARPAL-TUNNEL-SYNDROME
GERMAN RESEARCH NETWORK
PERIPHERAL NEUROPATHY
NERVE-CONDUCTION
PAIN PHENOTYPE
SYMPTOMS
QUESTIONNAIRE
PROFILES
STATISTICS
VALIDATION
Anesthesiology
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-03-22