Validation of the Czech Version of the Quantitative Sensory Testing Protocol

Czech version

Authors: I. Šrotová ^1,2; E. Vlčková ^1,2; J. Straková ¹; S. Kinclová ^1,2; B. Adamová ^1,2; L. Dušek ³; J. Jarkovský ³; J. Bednařík ^1,2
Authors‘ workplace: Neurologická klinika LF MU a FN Brno ¹; CEITEC – Středoevropský technologický institut, MU, Brno ²; Institut biostatistiky a analýz, LF a PřF MU, Brno ³
Published in: Cesk Slov Neurol N 2015; 78/111(4): 442-452
Category: Original Paper

Overview

Background:
Quantitative sensory testing (QST) following the protocol of the German Research Network on Neuropathic Pain (DFNS) is frequently used for the evaluation of sensory profi les in neuropathic pain patients. It covers a broad spectrum of sensory modalities using both nociceptive and non-nociceptive thermal and mechanical stimuli. The protocol requires the use of standardized instructions and thus necessitates validation of each language version.

Material and methods:
The standardized instructions for DFNS-QST protocol were translated using the forward-backward translation method and validated in a group of patients suffering from neuropathic pain of peripheral (n = 68) or central origin (n = 59) due to painful diabetic polyneuropathy or multiple sclerosis, and in a group of healthy volunteers (n = 75). The testing was repeated four times (with one-month interval between examinations) in 26 individuals to determine test-retest reliability.

Results:
In a group of healthy volunteers, 95% of values across all the parameters were within the physiological range based on published normal data. At least one sensory abnormity was found in 90% of neuropathic pain patients. Cluster analysis identified two distinctive pain profiles, the first mostly consisted of patients with painful diabetic neuropathy and the second of patients with pain in multiple sclerosis. Repeated administration confirmed an acceptable test-retest reliability (Cronbach´s alpha of 0.59–0.93 for the different sensory modalities).

Conclusion:
The Czech version of DFNS-QST protocol instructions displayed a good practical applicability in evaluating sensory abnormities in neuropathic pain patients, acceptable reliability and high internal consistency of the findings. The protocol provides results comparable to the original language version and can be recommended as an easy-to-apply and suitable testing method.

Key words:
neurological examination – sensory threshold – pain threshold – quantitative evaluation - neuropathic pain – diabetic neuropathy – multiple sclerosis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia‑ Larrea L et al. EFNS guidelines on neuropathic pain assessment: revised 2009. Eur J Neurol 2010; 17(8): 1010– 1018. doi: 10.1111/ j.1468‑ 1331.2010.02969.x.

2. Haanpää M, Attal N, Backonja M, Baron R, Bennett M, Bouhassira et al. NeuPSIG guidelines on neuropathic pain assessment. Pain 2011; 152(1): 14– 27. doi: 10.1016/ j.pain.2010.07.031.

3. Vlčková E, Šrotová I. Vyšetření senzitivity. Cesk Slov Neurol N 2014; 77/ 110(4): 402– 418.

4. Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S,Birklein F et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 2006; 10(1): 77– 88.

5. Rolke R, Baron R, Maier C, Tölle TR, Treede RD, Beyer Aet al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain 2006; 123(3): 231– 243.

6. Magerl W, Krumova EK, Baron R, Tölle T, Treede RD, Maier C. Reference data for quantitative sensory testing (QST): refined stratification for age and a novel method for statistical comparison of group data. Pain 2010; 151(3): 598– 605. doi: 10.1016/ j.pain.2010.07.026.

7. Treede RD, Jensen TS, Campbell JN, Cruccu G, Ostrovsky JO, Griffin JW et al. Neuropathic pain. Redefinition and a grading system for clinical and research purposes. Brain 2008; 70(18): 1630– 1635.

8. Šrotová I, Vlčková E, Straková J, Kincová S, Ryba L, Dušek L et al. Validace české verze Neuropathic Pain Symptom Inventory (NPSIcz). Cesk Slov Neurol N 2015; 78/ 111(1): 45– 56.

9. England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK,Carter GT et al. Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2005; 64(2): 199– 207.

10. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA,Filippi M et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011; 69(2): 292– 302. doi: 10.1002/ ana.22366.

11. Moravcová E, Bednařík J. Počítačem asistované stanovení termického prahu. Cesk Slov Neurol N 2003; 66/ 99(4): 263– 269.

12. Buršová Š, Vlčková E, Hnojčíková M, Němec M, Mičánková Adamová B, Bednařík J. Přístrojově asistované kvantitativní testování senzitivity – normativní data. Cesk Slov Neurol N 2012; 75/ 108(4): 444– 453.

13. Maier C, Baron R, Tölle TR, Binder A, Birbaumer N, Birklein F et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1,236 patients with different neuropathic pain syndromes. Pain 2010; 150(3): 439– 450. doi: 10.1016/ j.pain.2010.05.002.

14. Krumova EK, Geber C, Westermann A, Maier C.Neuropathic pain: is quantitative sensory testing helpful? Curr Diab Rep 2012; 12(4): 393– 402. doi: 10.1007/ s11892‑ 012‑ 0282‑ 7.

15. Bennett MI, Attal N, Backonja MM, Baron R, Bouhassira D, Freynhagen R et al. Using screening tools to identify neuropathic pain. Pain 2007; 127(3): 199– 203.

16. Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al. Development and validation of the Neuropathic Pain Symptom Inventory. Pain 2004; 108(3): 248– 257.

17. Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993; 36(2): 150– 154.

18. Osterberg A, Boivie J, Thuomas KA. Central pain in multiple sclerosis – prevalence and clinical characteristics. Eur J Pain 2005; 9(5): 531– 542.