• Title/Summary/Keyword: QST (quantitative sensory testing)

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Quantitative sensory Testing on Edema of Upper Extremity for Stroke Patients (뇌졸중 환자의 상지부종에 대한 정량적 감각 평가)

  • Lee, Young-Sin;Jung, Dae-In;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.851-859
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    • 2013
  • This study is conducted to provide basic data through the Quantitative Sensory Testing(QST) about edema of the upper extremity with hemiplegia for subacute and chronic patients in management and treatment. For the purposes of the study group I, subacute stroke patients(n = 15) and group II, chronic stroke patients(n = 17), was targeted, it was performed difference between the unaffected side and affected side of the upper extremity volume, MPT, CST, WST, CPT, WPT and QST of VST. As the results, all measurement items showed significant differences when comparing each group of all(p<.001), group I and group II of patients affected side, there was a significant difference in the measurements, with the exception of items MPT sensory test(p<.05). In subacute than chronic numbness due to increased sensory threshold appears in the upper extremity edema was able to confirm. It was focused on the difference in sensory properties according to the edema of stroke patients through quantitative test.

Effect of 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands evaluated by quantitative sensory testing

  • Okayasu, Ichiro;Komiyama, Osamu;Ayuse, Takao;De Laat, Antoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.6
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    • pp.361-365
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    • 2018
  • Background: Recently, we examined the effects of 2% lidocaine gel on the tactile sensory and pain thresholds of the face, tongue and hands of symptom-free individuals using quantitative sensory testing (QST); its effect was less on the skin of the face and hands than on the tongue. Consequently, instead of 2% lidocaine gel, we examined the effect of 8% lidocaine spray on the tactile sensory and pain thresholds of the skin of the face and hands of healthy volunteers. Methods: Using Semmes-Weinstein monofilaments, QST of the skin of the cheek and palm (thenar skin) was performed in 20 healthy volunteers. In each participant, two topical sprays were applied. On one side, 0.2 mL of 8% lidocaine pump spray was applied, and on the other side, 0.2 mL of saline pump spray was applied as control. In each participant, QST was performed before and 15 min after each application. Pain intensity was measured using a numeric rating scale (NRS). Results: Both the tactile detection threshold and filament-prick pain detection threshold of the cheek and thenar skin increased significantly after lidocaine application. A significant difference between the effect of lidocaine and saline applications was found on the filament-prick pain detection threshold only. NRS of the cheek skin and thenar skin decreased after application of lidocaine, and not after application of saline. Conclusion: The significant effect of applying an 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands can be objectively scored using QST.

Orofacial Thermal Quantitative Sensory Testing (QST): A Study of Healthy Korean Women and Sex Difference

  • Ahn, Sung-Woo;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.40 no.3
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    • pp.96-101
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    • 2015
  • Purpose: Thermal sensory test as an essential part of quantitative sensory testing (QST) has been recognized as a useful tool in the evaluation of the trigeminal nerve function. Normative data in the orofacial region have been reported but the data on differences in the test site, sex and ethnicity are still insufficient. Thus, this study aimed to investigate the normal range of orofacial thermal QST data in the healthy Korean women, and assess sex difference of thermal perception in the orofacial regions. Methods: Thermal QST was conducted on 20 healthy women participants (mean age, 26.4 years; range, 21 to 34 years). The thermal thresholds (cold detection threshold, CDT; warm detection threshold, WDT; cold pain threshold, CPT; and heat pain threshold, HPT) were measured bilaterally at the 5 trigeminal sites (the forehead, cheek, mentum, lower lip and tongue tip). The normative thermal thresholds of women in the orofacial region were evaluated using one-way ANOVA and compared with the previously reported data from age- and site-matched 30 healthy men (mean age, 26.1 years; range, 23 to 32 years) using two-way ANOVA. One experienced operator performed the tests of both sexes and all tests were done in the same condition except the time variability. Results: Women showed significant site differences for the CDT (p<0.001), WDT (p<0.001), and HPT (p=0.047) in the orofacial region. The CDT (p<0.001) and the CPT (p=0.007) presented significant sex difference unlike the WDT and the HPT. Conclusions: The thermal sensory evaluation in the orofacial region should be considered in the context of site and sex and the normative data in this study could be useful for assessment of the sensory abnormalities in the clinical setting.

The quantitative sensory testing is an efficient objective method for assessment of nerve injury

  • Kim, Young-Kyun;Yun, Pil-Young;Kim, Jong-Hwa;Lee, Ji-Young;Lee, Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.13.1-13.7
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    • 2015
  • Background: This study evaluated Somatosensory evoked potentials (SEP), Quantitative sensory testing (QST), and thermography as diagnostic methods for nerve injury. Methods: From 2006 through 2011, 17 patients (mean age: 50.1 years) from ${\bigcirc}{\bigcirc}{\bigcirc}{\bigcirc}$ Hospital who sought care for altered sensation after dental implant treatment were identified. The mean time of objective assessment was 15.2 months after onset. Results: SEP of Inferior alveolar nerve(IAN) was $15.87{\pm}0.87ms$ on the normal side and $16.18{\pm}0.73ms$ on the abnormal side. There was delayed N20 latency on the abnormal side, but the difference was not statistically significant. In QST, the abnormal side showed significantly higher scores of the current perception threshold at 2 KHz, 250 Hz, and 5 Hz. The absolute temperature difference was $0.55^{\circ}C$ without statistically significance. Conclusion: These results indicate that QST is valuable as an objective method for assessment of nerve injury.

Quantitative sudomotor axon reflex test (QSART) as a diagnostic tool of small fiber neuropathy

  • Suh, Bum Chun
    • Annals of Clinical Neurophysiology
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    • v.24 no.1
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    • pp.1-6
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    • 2022
  • Small fiber neuropathy is a painful neuropathy that cannot be assessed using nerve conduction studies. A skin biopsy and quantitative sensory testing (QST) are the gold standards for small fiber neuropathy diagnosis. However, a skin biopsy is invasive and commercially unavailable in Korea. QST is a method involving a thermal threshold, but its results can be affected by cognition as well as lesions of the central nervous system. Quantitative sudomotor axon reflex test (QSART) is a quantitative method of assessing sweat glands innervated by small fibers. In this review, we assessed the utility of QSART in evaluating small fiber neuropathy.

Effects of Fixed-intensity and Varied-intensity Electroacupuncture in Pain and Sensory Threshold in Patients with Chronic Tension Headache (전침 자극 강도에 따른 만성 긴장성 두통 환자의 통증과 감각역치 변화 연구)

  • Kwon, You-Jung;Lee, Dong-Hua;Lee, Ung-In;Park, Kyung-Mo;Lee, Sang-Hoon
    • Journal of Acupuncture Research
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    • v.29 no.4
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    • pp.25-34
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    • 2012
  • Objectives : This study was conducted to investigate the effects of fixed-intensity and varied-intensity electroacupuncture in pain and sensory threshold concerning parameters visual analogue scale(VAS), brief pain inventory(BPI) and quantitative sensory testing(QST), among chronic tension headache patients. Methods : Thirty patients with chronic tension headache were randomly assigned to three groups and received different kinds of electroacupuncture at $ST_{36}$ and $ST_{37}$. Group A received fixed-intensity electroacupuncture(fixed-EA), group B received varied-intensity electroacupuncture (varied-EA), and group C received only acupuncture treatment without electrical stimulation as a control group. The intervention was given three times per week, and continued in two weeks. All the experiments were conducted blindly. Results : Fixed-EA group showed a significant decrease of VAS and BPI compared to the baseline measurement, while both varied-EA and control group did not. Of the parameters of QST, subtraction of heat pain threshold(HPT) and cold pain threshold(CPT) slightly increased in all groups, but this was not significant. Conclusions : These results suggest that fixed-EA reduce pain and improve quality of life in patients with chronic tension headache and that acupuncture may regulate patient's pain sensitivity through changing sensory threshold.

A Pilot Study for Thermal Threshold Test of Trigeminal Nerve Injuries (삼차신경손상의 온도역치검사에 대한 예비연구)

  • Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.243-250
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    • 2012
  • Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

Clinical Features of the Persistent Idiopathic Dentoalveolar Pain Compared with Inflammatory Dental Pain

  • Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.47 no.2
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    • pp.87-94
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    • 2022
  • Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.

Effect of Neuro-Feedback Training and Transcutaneous Electrical Nerve Stimulation (TENS) in Stress, Quantitative Sensory Threshold, Pain on Tension Type Headache

  • Lee, Young-Sin;Lee, Dong-Jin;Han, Sang-Wan;Kim, Kyeong-Tae
    • The Journal of Korean Physical Therapy
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    • v.26 no.6
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    • pp.442-448
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    • 2014
  • Purpose: The objective of this study is to evaluate the effect of neuro-feedback training and transcutaneous electrical nerve stimulation (TENS) on stress, quantitative sensory threshold and pain in patients suffering from tension type headache. Methods: 22 participants who passed the preliminary evaluation were enrolled in the study and 11 participants were randomly assigned to each group. The control group (n=11) was subject to the TENS treatment of which was composed of a 20-minute session for 5 times a week during 4 weeks, and the experimental group (n=11) was subject to both neuro feedback training and TENS treatment for 10 minutes a day and 5 days a week during 4 weeks. The Perceived Stress Scale (PSS) was used to measure a level of stress and the quantitative sensory testing (QST) was used for the measurement of cold pain threshold (CPT) and heat pain threshold (HPT); A degree of pain was evaluated through the headache impact test-6 (HIT-6). Results: In comparision of all dependent variables between the control and subject groups, there were significant differences in stress, quantitative sensory threshold and pain after the treatment (p<0.05), and the experimental group showed significant differences in stress, CPT, HPT and pain (p<0.05) and the control group showed only a significant difference in HPT (p<0.05). Conclusion: Findings of this study demonstrate that the concomitant administration of the TENS treatment and neuro feedback training is effective on alleviation of stress, quantitative sensory threshold and pain in patients with tension type headache.

Reliability of Quantitative Sensory Testing Using Current Perception Thresholds in the Mandibular Nerve Area (하악신경영역에서 전류인지역치를 이용한 정량적 감각신경 검사의 재현성 조사)

  • Choi, Hee-Hun;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.131-137
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    • 2011
  • Current Perception Threshold (CPT) using Neurometer($Neurometer^{(R)}$ CPT/C) is thought as one of easy and noninvasive QST(qunatitative sensory testing) tools for A${\beta}$, A${\delta}$ and C fibers within a relatively short time. However, conflicts about its reliability still exist. This study aimed to evaluate the reliability of CPTs evaluation and find a way to increase its reliability. Two examiners separately tested CPTs at each side of the mandibluar nerve areas for ten healthy male adults (average age of 22.4 years) three times with an intervals of a week during three weeks. Mean CPTs were compared between the right and left sides of the mandibular nerve area and between the three examinations on the each side. While CPTs at 2000 Hz(A${\beta}$ fiber) showed statistically significant side differences in all three examinations (p<0.05), significant side difference was found in only one examination at 250 Hz(A${\delta}$ fiber) and no difference at 5 Hz(C fiber). Comparing CPTs on the each side of the mandibular nerve area, all examinations at all sensory nerve fibers showed the least CPTs at the 1st examinations. CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) were significantly different between the first and the following examinations (p<0.05) and there was no significant difference between 2nd and 3rd examinations. The results of this study indicated that CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) are reliable but CPTs at 2000 Hz(A${\beta}$ fiber) is not appropriate for evaluation of side differences in the mandibular nerve area. In addition, it is suggested that repeated examination be helpful to increase reliability of the CPT evaluation.