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用于评估感觉和疼痛处理变化的家庭定量感觉测试工具包的开发与验证:一项针对健康年轻成年人的研究。

Development and validation of a home quantitative sensory testing tool-kit to assess changes in sensory and pain processing: a study in healthy young adults.

作者信息

Ocay Don Daniel, Lobo Kimberly, Kim Angela, Halpin Meghan, Berde Charles B

机构信息

Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.

Department of Anaesthesia, Harvard Medical School, Boston, MA, United States.

出版信息

Pain. 2025 Jan 1;166(1):52-66. doi: 10.1097/j.pain.0000000000003320. Epub 2024 Jul 9.

Abstract

Quantitative sensory testing (QST) is a set of methods for quantifying somatosensory functioning. Limitations of laboratory-based QST (LQST) include high cost, complexity in training, lack of portability, and time requirements for testing. Translating QST to a home setting could facilitate future research and clinical care. The objective of this study was to develop a home QST (HQST) tool-kit that is cost-effective, easy to use, and detects changes in sensory and pain processing. Thirty-two young healthy adults underwent sensory testing on their nondominant forearm using standard in-person LQST, followed by "simulated HQST" using video guidance in a separate room from the investigator before and after application of either a lidocaine or capsaicin cream. We observed good agreement between HQST and LQST scores, with significant correlations observed between the pinprick, pressure, cold and heat measures (|ρ| range = 0.36-0.54). The participants rated the HQST protocol as highly acceptable and safe but can be improved in future implementations. Home QST was able to detect hypoesthesia to vibration after lidocaine cream application ( P = 0.024, d = 0.502) and could detect hypoalgesia and hyperalgesia to pressure and heat pain sensitivity tests after application of lidocaine and capsaicin creams, respectively ( P -value range = <0.001-0.036, d -value range = 0.563-0.901). Despite limitations, HQST tool-kits may become a cost-effective, convenient, and scalable approach for improving sensory profiling in clinical care and clinical research.

摘要

定量感觉测试(QST)是一组用于量化躯体感觉功能的方法。基于实验室的QST(LQST)的局限性包括成本高、培训复杂、缺乏便携性以及测试所需时间长。将QST转换到家庭环境中可以促进未来的研究和临床护理。本研究的目的是开发一种具有成本效益、易于使用且能检测感觉和疼痛处理变化的家庭QST(HQST)工具包。32名年轻健康成年人在其非优势前臂上使用标准的现场LQST进行感觉测试,然后在应用利多卡因或辣椒素乳膏前后,在与研究者分开的房间里使用视频指导进行“模拟HQST”。我们观察到HQST和LQST分数之间具有良好的一致性,在针刺、压力、冷觉和热觉测量之间观察到显著相关性(|ρ|范围 = 0.36 - 0.54)。参与者对HQST方案的评价是高度可接受和安全的,但在未来实施中可以改进。家庭QST能够检测到利多卡因乳膏应用后对振动的感觉减退(P = 0.024,d = 0.502),并且分别在应用利多卡因和辣椒素乳膏后,能够检测到压力和热痛敏感性测试中的痛觉减退和痛觉过敏(P值范围 = <0.001 - 0.036,d值范围 = 0.563 - 0.901)。尽管存在局限性,但HQST工具包可能成为一种具有成本效益、方便且可扩展的方法,用于改善临床护理和临床研究中的感觉分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5da/11647819/e71b0f161564/jop-166-052-g001.jpg

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