Mechanical detection and pain thresholds: comparability of devices using stepped and ramped stimuli
Author(s)
Type
Journal Article
Abstract
Quantitative sensory testing is used to assess somatosensory function in humans. The protocol of the German Research Network on Neuropathic Pain (DFNS) provides comprehensive normative values using defined tools; however, some of these may not be feasible in low-resource settings. Objectives: To compare the standard DFNS devices for assessment of mechanosensory function to a low resource tool, the Sorri-Bauru-monofilaments. Methods: Mechanical detection thresholds (MDT), pain thresholds (MPT), and suprathreshold pinprick ratings (pain sensitivity: MPS) were measured over cheek, hand dorsum, and fingertip in 13 healthy subjects (7 female, aged 21-44 years). Mechanical detection threshold was assessed with DFNS standard glass monofilaments (0.25-512 mN, 0.5 mm tip) and nylon monofilaments (Sorri-Bauru; 0.5-3000 mN). MPT was assessed with DFNS standard cylindrical probes (8-512 mN, 0.25 mm tip), Sorri-Bauru monofilaments, and with ramped stimuli using an electronic von Frey aesthesiometer (10 mN/s or 100 mN/s, 0.20 mm tip). MPS was measured in response to stepped and ramped pinpricks (128 and 256 mN). Results: Mechanical detection thresholds were the same for DFNS and Sorri-Bauru monofilaments. For MPT, Sorri-Bauru filaments yielded lower values than PinPricks over face but not hand. Pain thresholds were higher at all test sites for ramped than stepped pinpricks (P < 0.01). Suprathreshold ratings were lower for ramped than stepped pinpricks (P < 0.05). Conclusion: Sorri-Bauru filaments are acceptable substitutes for DFNS standards in estimating tactile sensitivity, but are not consistent with standard probes for pinprick sensitivity because of their nonstandardized tips. Ramped stimuli overestimated MPT and underestimated MPS due to reaction time artefacts and therefore need their own normative values.
Date Issued
2020-11-01
Online Publication Date
2021-02-11T10:09:41Z
Date Acceptance
2020-08-26
ISSN
2471-2531
Publisher
Lippincott, Williams & Wilkins
Start Page
1
End Page
8
Journal / Book Title
PAIN Reports
Volume
5
Issue
6
Copyright Statement
©2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. This is an open access articledistributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike License 4.0 (CC BY-NC-SA) which allows others to remix,tweak, and buildupon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33294759
PAINREPORTS-D-20-0052
Subjects
DFNS
Quantitative sensory testing
hyperalgesia
pinprick
sensory loss
DFNS
Quantitative sensory testing
hyperalgesia
pinprick
sensory loss
Publication Status
Published
Country
United States
Article Number
ARTN e865