Dias Patrícia, Tavares Isaura, Fonseca Sara, Pozza Daniel Humberto
Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal.
Biomedicines. 2023 Mar 27;11(4):1023. doi: 10.3390/biomedicines11041023.
Chronic pain is an important cause of disability with a high burden to society. Quantitative sensory testing (QST) is a noninvasive multimodal method used to discriminate the function of nerve fibers. The aim of this study is to propose a new, reproducible, and less time-consuming thermal QST protocol to help characterize and monitor pain. Additionally, this study also compared QST outcomes between healthy and chronic pain subjects. Forty healthy young/adult medical students and fifty adult/elderly chronic pain patients were evaluated in individual sessions including pain history, followed by QST assessments divided into three proposed tests: pain threshold, suprathreshold, and tonic pain. In the chronic pain group, a significantly higher pain threshold (hypoesthesia) and a higher pain sensibility (hyperalgesia) were demonstrated at threshold temperature when compared to healthy participants. The sensitivity to the suprathreshold and tonic stimulus did not prove to be significantly different between both groups. The main results demonstrated that the heat threshold QST tests can be helpful in evaluating hypoesthesia and that the sensitivity threshold temperature test can demonstrate hyperalgesia in individuals with chronic pain. In conclusion, this study demonstrates the importance of using tools such as QST as a complement to detect changes in several pain dimensions.
慢性疼痛是导致残疾的一个重要原因，给社会带来了沉重负担。定量感觉测试（QST）是一种用于区分神经纤维功能的非侵入性多模态方法。本研究的目的是提出一种新的、可重复且耗时较少的热定量感觉测试方案，以帮助对疼痛进行特征描述和监测。此外，本研究还比较了健康受试者和慢性疼痛受试者的定量感觉测试结果。对40名健康的年轻/成年医学生和50名成年/老年慢性疼痛患者进行了单独评估，评估内容包括疼痛病史，随后进行定量感觉测试，分为三个建议测试：疼痛阈值、阈上刺激和持续性疼痛。与健康参与者相比，慢性疼痛组在阈值温度下表现出显著更高的疼痛阈值（感觉减退）和更高的疼痛敏感性（痛觉过敏）。两组之间对阈上刺激和持续性刺激的敏感性没有显著差异。主要结果表明，热阈值定量感觉测试有助于评估感觉减退，而敏感性阈值温度测试可以显示慢性疼痛个体的痛觉过敏。总之，本研究证明了使用定量感觉测试等工具作为补充来检测多个疼痛维度变化的重要性。
