Department of Pain Medicine, The Walton Centre NHS Trust, Liverpool, UK.
Saluda Medical Europe Ltd, Harrogate, UK.
Neuromodulation. 2024 Aug;27(6):1026-1034. doi: 10.1016/j.neurom.2024.03.005. Epub 2024 Apr 18.
Quantitative sensory testing (QST) has been used for decades to study sensory abnormalities in multiple conditions in which the somatosensory system is compromised, including pain. It is commonly used in pharmacologic studies on chronic pain but less so in conjunction with neuromodulation. This review aims to assess the utility of QST in spinal cord stimulation (SCS) protocols.
For this narrative review, we searched PubMed for records of studies in which sensory testing has been performed as part of a clinical study on SCS from 1975 onward until October 2023. We focused on studies in which QST has been used to explore the effect of SCS on neuropathic, neuropathic-like, or mixed pain.
Our search identified 22 useful studies, all small and exploratory, using heterogeneous methods. Four studies used the full battery of validated German Research Network on Neuropathic Pain QST. There is emerging evidence that assessment dynamic mechanical allodynia (eight studies), and mechanical/thermal temporal summation of pain (eight studies) may have a role in quantifying the response to various SCS waveforms. There also were sporadic reports of improvement of sensory deficits in a proportion of patients with neuropathic pain that warrant further study.
We recommend the adoption of QST into future clinical research protocols, using either the full QST protocol or a less time-demanding short-form QST.
定量感觉测试（QST）已被用于研究数十年，以研究感觉系统受损的多种情况下的感觉异常，包括疼痛。它常用于慢性疼痛的药理学研究，但与神经调节结合使用较少。本综述旨在评估 QST 在脊髓刺激（SCS）方案中的应用。
为了进行这篇叙述性综述，我们在 PubMed 上搜索了自 1975 年以来至 2023 年 10 月期间，将感觉测试作为 SCS 临床研究一部分进行的记录。我们专注于使用 QST 探索 SCS 对神经性、神经性样或混合性疼痛影响的研究。
我们的搜索确定了 22 项有用的研究，均为小型探索性研究，采用了不同的方法。四项研究使用了经过验证的德国神经病理性疼痛 QST 网络的完整测试套件。有越来越多的证据表明，评估动态机械性触诱发痛（八项研究）和机械/热痛的时间总和（八项研究）可能在量化对各种 SCS 波形的反应方面具有作用。也有少数报告称，神经性疼痛患者中的一部分患者的感觉缺陷得到改善，这值得进一步研究。
我们建议在未来的临床研究方案中采用 QST，使用完整的 QST 方案或耗时较少的简短 QST。
