Rolke R, Magerl W, Campbell K Andrews, Schalber C, Caspari S, Birklein F, Treede R-D
Institute of Physiology and Pathophysiology, Johannes Gutenberg-University, Saarstr. 21, D-55099 Mainz, Germany.
Eur J Pain. 2006 Jan;10(1):77-88. doi: 10.1016/j.ejpain.2005.02.003.
We have compiled a comprehensive QST protocol as part of the German Research Network on Neuropathic Pain (DFNS) using well established tests for nearly all aspects of somatosensation. This protocol encompasses thermal as well as mechanical testing procedures. Our rationale was to test for patterns of sensory loss (small and large nerve fiber functions) or gain (hyperalgesia, allodynia, hyperpathia), and to assess both cutaneous and deep pain sensitivity. The practicality of the QST protocol was tested in 18 healthy subjects, 21-58 years, half of them female. All subjects were tested bilaterally over face, hand and foot. We determined thermal detection and pain thresholds including a test for the presence of paradoxical heat sensations, mechanical detection thresholds to von Frey filaments and a 64-Hz tuning fork, mechanical pain thresholds to pinprick stimuli and blunt pressure, stimulus-response-functions for pinprick and dynamic mechanical allodynia (pain to light touch), and pain summation (wind-up ratio) using repetitive pinprick stimulation. The full protocol took 27+/-2.3 min per test area. The majority of QST parameters were normally distributed only after logarithmic transformation (secondary normalization) except for the frequency of paradoxical heat sensations, cold and heat pain thresholds, and for vibration detection thresholds. Thresholds were usually lowest over face, followed by hand, and then foot. Only thermal pain thresholds, wind-up ratio and vibration detection thresholds were not significantly dependent on the body region. There was no significant right-to-left difference for any of the QST parameters; left-to-right correlation coefficients ranged between 0.78 and 0.97, thus explaining between 61% and 94% of the variance. This study has shown that a complete somatosensory profile of one affected area and one unaffected control area, which will be necessary to characterize patients with a variety of diseases, can be obtained within 1 h. Case examples of selected patients illustrate the value of z-transformed QST data for an easy survey of individual symptom profiles.
作为德国神经性疼痛研究网络（DFNS）的一部分，我们编制了一份全面的定量感觉测试（QST）方案，该方案采用了针对几乎所有躯体感觉方面的成熟测试。此方案涵盖了热学以及力学测试程序。我们的基本原理是测试感觉丧失（小神经纤维和大神经纤维功能）或感觉增强（痛觉过敏、异常性疼痛、痛性感觉迟钝）的模式，并评估皮肤和深部疼痛敏感性。该QST方案的实用性在18名年龄在21至58岁之间的健康受试者中进行了测试，其中一半为女性。所有受试者均在面部、手部和足部进行双侧测试。我们测定了热觉检测阈值和疼痛阈值，包括对反常热感觉存在情况的测试、对von Frey细丝和64赫兹音叉的力学检测阈值、对针刺刺激和钝性压力的力学疼痛阈值、针刺和动态机械性异常性疼痛（轻触疼痛）的刺激 - 反应函数，以及使用重复针刺刺激的疼痛总和（累积比率）。每个测试区域完成整个方案需要27±2.3分钟。除了反常热感觉的频率、冷痛和热痛阈值以及振动检测阈值外，大多数QST参数仅在对数转换（二次标准化）后呈正态分布。阈值通常在面部最低，其次是手部，然后是足部。只有热痛阈值、累积比率和振动检测阈值与身体部位无显著相关性。任何QST参数在左右之间均无显著差异；左右相关系数在0.78至0.97之间，因此解释了61%至94%的方差。这项研究表明，对于患有各种疾病的患者进行特征描述所必需的一个受影响区域和一个未受影响对照区域的完整躯体感觉概况，可在1小时内获得。所选患者的病例示例说明了z变换后的QST数据对于轻松调查个体症状概况的价值。
