• Neuromodulation · Apr 2024

    Review

    Quantitative Sensory Testing in Spinal Cord Stimulation: A Narrative Review.

    • Turo Nurmikko, Dave Mugan, Angela Leitner, and HuygenFrank J P MFJPMCenter for Pain Medicine, Erasmus University Medical Center, Rotterdam and UMCU, Utrecht, The Netherlands..
    • Department of Pain Medicine, The Walton Centre NHS Trust, Liverpool, UK. Electronic address: turo.nurmikko@gmail.com.
    • Neuromodulation. 2024 Apr 18.

    ObjectivesQuantitative sensory testing (QST) has been used for decades to study sensory abnormalities in multiple conditions in which the somatosensory system is compromised, including pain. It is commonly used in pharmacologic studies on chronic pain but less so in conjunction with neuromodulation. This review aims to assess the utility of QST in spinal cord stimulation (SCS) protocols.Materials And MethodsFor this narrative review, we searched PubMed for records of studies in which sensory testing has been performed as part of a clinical study on SCS from 1975 onward until October 2023. We focused on studies in which QST has been used to explore the effect of SCS on neuropathic, neuropathic-like, or mixed pain.ResultsOur search identified 22 useful studies, all small and exploratory, using heterogeneous methods. Four studies used the full battery of validated German Research Network on Neuropathic Pain QST. There is emerging evidence that assessment dynamic mechanical allodynia (eight studies), and mechanical/thermal temporal summation of pain (eight studies) may have a role in quantifying the response to various SCS waveforms. There also were sporadic reports of improvement of sensory deficits in a proportion of patients with neuropathic pain that warrant further study.ConclusionsWe recommend the adoption of QST into future clinical research protocols, using either the full QST protocol or a less time-demanding short-form QST.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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