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Clinical Interpretation of Quantitative Sensory Testing as a Measure of Pain Sensitivity in Patients With Sickle Cell Disease. J Pediatr Hematol Oncol 2016 05;38(4):288-93 PMID: 26907660 PMCID: PMC4856159

Pubmed ID

26907660

DOI

10.1097/MPH.0000000000000532

Abstract

Patients with sickle cell disease (SCD) display significantly lower mean/median thermal and mechanical pain thresholds compared with controls. This suggests impaired pain sensitivity where stimuli produce exaggerated pain. Despite these mean/median differences, clinicians need to understand if patients meet criteria for impaired pain sensitivity. We defined thresholds for impaired cold, heat, and mechanical pain sensitivity in SCD patients. Using quantitative sensory testing (QST) we assessed cold, heat, and mechanical pain thresholds in SCD patients and African American controls aged 7 years and above. Impaired pain sensitivity was defined as: (1) cold pain threshold 1 SD above control median threshold; (2) heat pain threshold 1 SD below control median threshold; and (3) mechanical pain threshold 1 SD below control median threshold. Fifty-five SCD patients and 57 controls participated in this study. Impaired pain sensitivity thresholds were: (1) cold: 17.01°C, (2) heat: 43.91°C, and (3) mechanical: 4.42 g. Impaired cold pain sensitivity was the most common finding (63.6%), then heat (60%), and mechanical (38.2%). Impaired pain sensitivity to ≥1 testing modalities occurred in 81.8% of SCD patients. Determining impaired pain sensitivity thresholds increases clinical utility of QST. QST could be a screening tool to phenotype SCD pain, an outcome for pain interventional trials, or guide pain neurobiology investigations.

Author List

Brandow AM, Panepinto JA

Authors

Amanda Brandow DO Associate Professor in the Pediatrics department at Medical College of Wisconsin
Julie A. Panepinto MD, MSPH Professor in the Pediatrics department at Medical College of Wisconsin




Scopus

2-s2.0-84959170292   6 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Anemia, Sickle Cell
Case-Control Studies
Child
Cold Temperature
Cross-Sectional Studies
Female
Hot Temperature
Humans
Male
Mechanical Phenomena
Pain Measurement
Pain Threshold
Sensory Thresholds
Young Adult
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5