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Lesions in the peripheral or central nervous system can cause chronic pain ("neuropathic pain"). In this project we developed a standardized protocol of Quantitative Sensory Testing (QST) for the German Research Network Neuropathic Pain and supervise the creation of a normative database and multicenter therapy studies.
QST training
In the DFNS training center at the Department of Neurophysiology of the Mannheim Medical Faculty of the University of Heidelberg, standardized training contents are taught according to Certkom criteria. The training duration is approximately 8 hours. An assessment of the correct application of individual test stimuli is carried out at the end of the training day.
Flyer for the QST training (pdf)
Training content
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QST Device List
Equipment manufacturers for quantitative sensory testing according to the rules of the German Neuropathic Pain Research Network (DFNS):
QST Methodology
Simplified description of the Quantitative Sensory Testing (QST) method (excerpt from the information sheet for QST tests on healthy volunteers)
Heat and cold
The first step is to test your sensitivity to heat and cold and your perception of cold and heat pain. This is done by placing an approx. 13 cm2 metal surface is placed on your skin. This has an initial temperature of 32°C, which will increases or decreases in a predetermined sequence. As soon as you perceive changes in temperature or pain sensations on the surface, we will ask you to press a stop button, which will return the metal surface to its initial temperature. This process will be repeated 3 times for each temperature change in each test area.
Touch
This is followed by a test of your perception thresholds for touch and needle stimuli, using a hair and a needle at different pressures on the skin. This is followed by a test to see if you experience pain when touched, known as allodynia. This is done by touching the skin with a wad of cotton wool, a Q-tip and a standardized brush, or by applying light pressure to the skin. In another test, a single stimulus is applied to the skin with a blunt needle. In an interval of ten seconds, a series of ten identical needle stimuli follows within the same skin area. Immediately after the single stimulus, as well as after the subsequent series of stimuli, an overall evaluation of the intensity of sensation will be made using a numerical scale from 0-100.
Vibration threshold
To test the vibration threshold, a tuning fork will be placed on the skin above a bony prominence (e.g. on the inner ankle for the feet, on the wrist for the hands on the head over the lateral part of the scalp).
Pressure sensitivity
To test the perception of muscular pressure sensitivity, a pressure stimulator placed over defined muscles (e.g. above the inner foot muscle for the feet, above the thumb ball for the hands, above the temple region for the face). By increasing the pressure intensity, the pressure pain threshold can be determined over the muscles.
