• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.851-859
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• 2013

본 연구는 뇌졸중 편마비 환자를 대상으로 비마비측과 상지부종이 있는 마비측의 정량적 감각 평가(QST)를 비교함으로서 부종 관리 및 치료에 대한 기초자료를 제공하고자 하였다. 연구의 목적에 맞는 아급성기 뇌졸중 환자I군(n=15)과 만성기 뇌졸중 환자II군(n=17)을 대상으로 비마비측과 마비측에 대한 상지용적의 차이, 기계적 동통 역치(MPT), 냉감역치(CST), 온감역치(WST), 냉통증역치(CPT), 온통증역치(WPT), 진동감각 역치(VST)에 대한 정량적 감각 평가(QST)를 실시하였다. 그 결과, 각 군내 비교 시 모든 측정 항목에서 유의한 차이가 나타났고(p<.001), I군과 II군의 군간 마비측 감각 평가 비교에서는 기계적 동통 역치(MPT)를 제외한 모든 측정 항목에서 유의한 차이가 나타났다(p<.05). 아급성기에는 만성기에 비해 상지부종으로 감각역치 증가로 인한 감각저하가 초래되었음을 확인할 수 있었다. 뇌졸중 환자의 부종에 따른 감각적 특성 차이를 정량적 평가를 통해 알아보고자 하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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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.

• Journal of Oral Medicine and Pain
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• 제40권3호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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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.

• Annals of Clinical Neurophysiology
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• 제24권1호
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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.

• Journal of Acupuncture Research
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• 제29권4호
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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.

• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.243-250
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• 2012

임플란트 수술이나 발치 같은 침습적인 치과치료로 인한 삼차신경 손상의 증가는 최근 치과계의 가장 민감한 문제의 하나로서 향후 법적인 문제로 까지 이어질 수 있다. 그러므로 신경손상에 대한 객관적이고 신뢰성 있는 평가 즉, 정량적 감각신경 검사(quantitative sensory testing)의 필요성이 강조되고 있으며, 온도역치 검사는 QST의 필수 항목으로 구강영역에서도 신뢰성이 입증되어 있다. 국내에서는 삼차신경손상과 관련한 온도역치 검사에 대한 보고가 아직 없기에, 본원에서 시행한 일부 증례의 온도역치 검사의 결과를 평가하고자 하였다. 2011년 5월부터 2012년 10월까지 단국대학교 치과대학 부속 치과병원 구강내과에 내원한 삼차신경손상이 의심되는 환자중 온도역치 검사를 시행한 18명의 환자 자료를 분석하였다. 환자들의 냉인지역치(cold detection threshold, CDT)는 이환측이 비이환측에 비해 유의하게 낮았으나 온인지역치(warm detection threshold, WDT), 냉통각역치(cold pain threshold, CPT), 열통각역치(heat pain threshold, HPT)는 통계적 차이를 보이지 않았다. 향후 더 많은 피검자를 대상으로 온도 자극과 관련하여 감각저하나 감각과민, 통각저하나 통각과민 같은 유형별 비교 연구가 필요하다.

• Journal of Oral Medicine and Pain
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• 제47권2호
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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.

• The Journal of Korean Physical Therapy
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• 제26권6호
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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.

• Journal of Oral Medicine and Pain
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• 제36권2호
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• pp.131-137
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• 2011

신경 손상 정도를 평가하기 위한 정량적감각평가(Quantitative Sensory Testing, QST) 방법 중 하나인 전류인지역치(Current Perception Threshold, CPT) 검사는 비교적 짧은 시간 내에 3가지 감각신경, 2000 Hz(A${\beta}$ fiber), 250 Hz(A${\delta}$ fiber), 5 Hz(C fiber)에 대한 기능을 평가 할 수 있다고 알려져 있지만, 그 재현성에 대해서는 여전히 상반된 견해가 존재한다. 본 연구는 CPT 검사의 재현성을 확인하고, 재현성을 향상시키기 위한 방법을 모색하고자 하였다. 건강한 남성 지원자 10명(평균 22.4세)을 대상으로 3주 동안 1주일 간격으로 2명의 검사자가 하악신경 영역을 각각 좌우로 나누어 3회 측정하여 비교 하였다. 3주에 걸친 측정 실험에서 2000 Hz(A${\beta}$ fiber)의 CPT는 3회 모두 좌우 측정치가 차이를 보인 반면(p<0.05), 250Hz(A${\delta}$ fiber)는 1회만 유의한 차이를 보였고(p<0.05), 5 Hz(C fiber)는 유의한 차이를 보이지 않았다. 좌우를 나누어 3회의 실험을 비교했을 때 모든 신경 검사에서 첫 회의 CPT가 가장 낮았으며, 250 Hz(A${\delta}$ fiber)와 5 Hz(C fiber)의 CPT는 첫 번째 실험과 나머지 실험사이에 유의한 차이가 있었고(p<0.05), 두 번째 실험 이후로 유의한 차이가 없었다. 상기의 결과로 보아 2000 Hz(A${\beta}$ fiber)의 CPT를 이용한 좌우 신경의 기능 비교는 적절하지 않은 반면, 250 Hz(A${\delta}$ fiber)와 5 Hz(C fiber)에서는 좌우 비교가 가능할 것으로 생각된다. 또한 반복 측정을 통해 250 Hz(A${\delta}$ fiber)와 5 Hz(C fiber)의 CPT 검사의 재현성을 높일 수 있을 것으로 판단된다.