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ORIGINAL ARTICLES
Reliability of Static and Dynamic Quantitative Sensory Testing in Patients With Painful Chronic Pancreatitis
  1. Søren S. Olesen, MD, PhD*,
  2. Harry van Goor, MD, PhD†,
  3. Stefan A.W. Bouwense, MD†,
  4. Oliver H.G. Wilder-Smith, MBChB, MD, PhD‡,§ and
  5. Asbjørn M. Drewes, MD, PhD, DMSci*,§
  1. From the *Mech-Sense, Department of Gastroenterology, Aalborg Hospital, Aarhus University Hospital, Aarhus N, Denmark;
  2. †Pain and Nociception Neuroscience Research Group, Departments of Surgery and
  3. ‡Anesthesiology, Pain and Palliative Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; and
  4. §Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  1. Address correspondence to: Søren S. Olesen, MD, PhD, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg Hospital, Aarhus University Hospital, Mølleparkvej 4, 9000 Aalborg, Denmark (e-mail: sso{at}mech-sense.com).

Abstract

Background and Objectives Quantitative sensory testing (QST) has proven to be an important instrument to characterize mechanisms underlying somatic and neuropathic pain disorders. However, its reliability has not previously been established in patients with visceral pain. We investigated the test-retest reliability of static and dynamic QST in patients with visceral pain due to chronic pancreatitis.

Methods Sixty-two patients (38 men, 53 [11] y) with painful chronic pancreatitis were included. Static QST comprised sensory thresholds for pressure and electrical stimulation performed in the ventral and dorsal T10 dermatomes (sharing spinal innervation with the pancreas, ie, pancreatic viscerotomes) and in 4 heterologous regions (control areas). Dynamic QST comprised conditioned pain modulation. Measurements were obtained from 2 subsequent test sessions separated by 1 week.

Results The reliability of static QST was generally high, with the best test-retest performance seen for pressure pain thresholds (intraclass correlation coefficients [ICC], 0.74) and electrical sensation thresholds (ICC, 0.66). In contrast, the reliability of dynamic QST was poor (ICC, 0.01). For static QST measures, the reliability was higher for pain thresholds compared with suprapain thresholds (P < 0.01). No differences between assessments in the pancreatic viscerotomes compared with heterologous regions were seen (P = 0.6).

Conclusions Sensory thresholds in the pancreatic viscerotomes and control areas were reproducible over time. In contrast, dynamic QST measurements reflecting active central modulation of pain processing state (ie, conditioned pain modulation) were not stable over time and showed considerable variability. These factors should be taken into consideration in case QST is used to follow disease mechanisms, drug effects, or effects of pain intervention.

https://doi.org/10.1097/AAP.0b013e3182632c40

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    Footnotes

    • The authors declare no conflict of interest.

    • This research was supported by Karen Elise Jensen’s Foundation, Hertha Christensen’s Foundation, and Christenson-Ceson’s Family Foundation.