Wandrey Jan D, Reinecke Annika, Westermann Andrea, Lücke Thomas, Enax-Krumova Elena, Maier Christoph, Vollert Jan, Eitner Lynn
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Berlin, Germany.
Eur J Pain. 2025 Aug;29(7):e70078. doi: 10.1002/ejp.70078.
Mechanical detection thresholds (MDTs) are used to assess somatosensory function but can only be evaluated considering the individual sex, age and tested body region. The German Research Network on Neuropathic Pain (DFNS) provides reference values for OptiHair2, a sensitive and expensive glass filament, while nylon filaments such as the Aesthesiometer II are more durable and affordable. In this study, we compare both devices regarding their use for MDT assessment in a variety of participants, thus intending to achieve a higher range for MDT.
MDTs of healthy children (< 18y), healthy adults (> 18y) and adult patients with symptoms of suspected polyneuropathy were determined using OptiHair2 glass filaments (0.25-512mN) and Aesthesiometer II nylon filaments (0.63-235.36mN), using the method of limits according to the DFNS protocol. Testing was performed on the cheek, hand and foot in healthy participants; patients were tested on the hand and foot only. Concordance Correlation Coefficient (CCC), Pearson correlation and linear regression analysis were performed.
The study included 55 participants (33 female, 30 healthy adults aged 22-62 years, 10 healthy children aged 9-15 years, 15 patients aged 35-86 years). There was a relevant concordance of MDTs between Aesthesiometer II and OptiHair2 at the hand (CCC children = 0.14, healthy adults = 0.56, patients = 0.66) and foot (CCC children = 0.24, healthy adults = 0.66, patients = 0.70) but not on the cheek (CCC children = 0.00, healthy adults = 0.01).
The Aesthesiometer II can be a viable replacement for OptiHair2 in less densely innervated areas like the feet, when screening for polyneuropathy, especially in bedside settings due to its robust materials. However, its stronger lowest force (0.63 vs. 0.25 mN) implicates poorer sensitivity for MDT assessments when testing highly innervated areas like the face.
This study suggests the use of robust Aesthesiometer II nylon filaments as an alternative to the more fragile OptiHair2 glass filaments for MDT assessments. While we find that only OptiHair2 seems to be suitable for more densely innervated areas like the face, Aesthesiometer II's durability and cost-efficiency make it a useful bedside tool, especially for assessing suspected polyneuropathy in less densely innervated areas like the feet.
机械检测阈值（MDT）用于评估躯体感觉功能，但只能结合个体的性别、年龄和测试的身体部位进行评估。德国神经性疼痛研究网络（DFNS）提供了OptiHair2（一种灵敏但昂贵的玻璃丝）的参考值，而尼龙丝（如II型触觉测量仪）更耐用且价格更低。在本研究中，我们比较了这两种设备在各类参与者中用于MDT评估的情况，旨在获得更广泛的MDT范围。
使用OptiHair2玻璃丝（0.25 - 512mN）和II型触觉测量仪尼龙丝（0.63 - 235.36mN），根据DFNS方案采用极限法，测定健康儿童（<18岁）、健康成年人（>18岁）以及有疑似多发性神经病症状的成年患者的MDT。在健康参与者的脸颊、手部和足部进行测试；患者仅在手部和足部进行测试。进行一致性相关系数（CCC）、Pearson相关性和线性回归分析。
该研究纳入了55名参与者（33名女性，30名年龄在22 - 62岁的健康成年人，10名年龄在9 - 15岁的健康儿童，15名年龄在35 - 86岁的患者）。II型触觉测量仪和OptiHair2在手部（CCC儿童 = 0.14，健康成年人 = 0.56，患者 = 0.66）和足部（CCC儿童 = 0.24，健康成年人 = 0.66，患者 = 0.70）的MDT之间存在显著一致性，但在脸颊上不存在（CCC儿童 = 0.00，健康成年人 = 0.01）。
在筛查多发性神经病时，II型触觉测量仪在像足部这样神经分布较少的区域可以成为OptiHair2的可行替代品，特别是在床边环境中，因其材料坚固。然而，其最低力更强（0.63对0.25 mN）意味着在测试像面部这样神经分布密集的区域时，对MDT评估的敏感性较差。
本研究表明，在MDT评估中，使用坚固的II型触觉测量仪尼龙丝可替代更易碎的OptiHair2玻璃丝。虽然我们发现只有OptiHair2似乎适用于像面部这样神经分布密集的区域，但II型触觉测量仪的耐用性和成本效益使其成为一种有用的床边工具，特别是用于评估像足部这样神经分布较少区域的疑似多发性神经病。
