Table 2 Tests from a previous systematic review
From: Tests for central sensitization in general practice: a Delphi study
Measurement test | What is measured? | Examples |
|---|---|---|
Quantitative sensory testing (QST) | Hyperalgesia, allodynia, temporal summation | Thermal stimuli: thresholds for cold pain, heat pain, cold detection and heat detection; e.g., putting the hand in an iced water bath Tactile stimuli: pressure pain thresholds (PPTs) Vibratory or vibrotactile stimuli: detection thresholds for vibration or a combination of tactile and vibratory stimuli, e.g., electric toothbrush Electrical stimuli: reaction to electrical pulses with electrodes Distention: distending the rectum or oesophagus with an inflatable balloon Ischemic stimuli: ischemic compression of the arm with a cuff Reaction on specific pain mediators, e.g. reaction on injection with hypertonic saline |
Two different quantitative sensory tests together | Conditioned pain modulation (CPM) | Tonic phasic stimulation: phasic heat test with counter irritation of cold Ischemic stimulation: inflating an occlusion cuff, comparing pressure pain prior to and during cuff inflation The nociception withdrawal reflex e.g. H(offman) reflex: stimulation of median nerve with an EMG device, measurement of H wave (a compound muscle action potential) Measurement of the cutaneous silent period (CSP): a brief pause in muscle action potentials following strong stimulation of a cutaneous nerve during a sustained voluntary contraction |
MRIa, fMRIa, PETa, somatosensory evoked potentials (SEP)a | Structural and functional brain changes | Measurement of changes in brain morphology (global and regional grey matter volumes), changes in density and changes in signalling |
Measurement of cytokine levels | Laboratory evaluation | Measurement of serum levels of pro-inflammatory interleukins (Il-1, IL-6, IL-8) and anti-inflammatory interleukins (IL-4, IL-10); serum levels of TNF-alpha, a pro-inflammatory cytokine |
Measurement of neurotrophin levels | Laboratory evaluation | Measurement of serum levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) |
Questionnaires | Symptoms, history of functional syndromes | Central Sensitization Inventory (CSI) |
Sensory aspects of hypersensitivity | Sensory Hypersensitivity Scale (SHS) |