ZNAČAJ PRIMENE KVANTITATIVNOG SENZORNOG TESTIRANJA KOD PACIJENATA SA HRONIČNIM MUSKULOSKELETNIM BOLOM
Sažetak
Kvantitativno senzorno testiranje (engl. quantitatory sensory testing ‒ QST) pruža objektivne, ponovljive podatke koji mogu pomoći u potvrđivanju dijagnoze ili u praćenju ishoda lečenja kod pacijenata sa hroničnim muskuloskeletnim bolom (engl. chronic musculoskeletal pain ‒ CMSP). QST može otkriti rane senzorne promene pre nego što one postanu klinički očigledne. Budući da QST procedure nisu invazivne, pogodne su za ponovljene procene i dugotrajno praćenje. Standardizacija protokola testiranja od ključnog je značaja za dobijanje pouzdanih rezultata. Oslabljena modulacija bola uslovljena kondicioniranjem (engl. conditioned pain modulation ‒ CPM) mogla bi poslužiti kao biomarker za centralnu senzitizaciju u hroničnim bolnim stanjima i pomoći kliničarima da identifikuju pacijente čiji je bol centralno posredovan. QST ima potencijala da postane sastavni deo rutinskih kliničkih evaluacija u različitim hroničnim mišićno-skeletnim stanjima. QST je posebno značajan u proceni efekta fizikalnih terapija, programa vežbi i psihološke terapije.
Reference
Aleksandar Knezevic, Milena Kovacevic, Milica Jeremic-Knezevic, Zeljka Nikolasevic, Snezana Tomasevic-Todorovic, Zeljko Zivanovic, et al. Patients with neuropathic pain from lumbosacral radiculopathy demonstrate similar pressure pain thresholds and conditioned pain modulation to those with fibromyalgia. Neurophysiologie Clinique 202353;53(4): 102841 [CrossRef] [PubMed]
Alsouhibani A, Hoeger Bement M. Impaired conditioned pain modulation was restored after a single exercise session in individuals with and without fibromyalgia. Pain Rep 2022;7(3): e996. [CrossRef] [PubMed]
Arendt-Nielsen L, Yarnitsky D. Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain 2009; 10:556–72. [CrossRef] [PubMed]
Castelo-Branco L, Cardenas-Rojas A, Rebello-Sanchez I, Pacheco-Barrios K, de Melo PS, Gonzalez-Mego P, et al. Temporal Summation in Fibromyalgia Patients: Comparing Phasic and Tonic Paradigms. Front Pain Res (Lausanne) 2022;3:881543. [CrossRef] [PubMed]
Chong PST, Cros DP. Technology literature review: Quantitative sensory testing. Muscle Nerve 2004;29:734–47. [CrossRef] [PubMed]
Clark J, Nijs J, Yeowell G, Goodwin PC. What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review. Pain Physician 2017;20(6):487-500. [CrossRef] [PubMed]
Cruz-Almeida Y, Fillingim RB. Can quantitative sensory testing move us closer to mechanism-based pain management? Pain Med 2014;15(1):61-72. [CrossRef] [PubMed]
Damien J, Colloca L, Bellei-Rodriguez CÉ, Marchand S. Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain. Int Rev Neurobiol 2018;139:255-96. [CrossRef] [PubMed]
Domingues L, Pimentel-Santos FM, Cruz EB, Sousa AC, Santos A, Cordovil A, et al. Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial. Clin Rehabil 2019;33(12):1908-18. [CrossRef] [PubMed]
Granovsky Y, Yarnitsky D. Personalized pain medicine: the clinical value of psychophysical assessment of pain modulation profile. Rambam Maimonides Med J 2013;4(4):e0024. [CrossRef] [PubMed]
IASP. Global year against musculoskeletal pain: epidemiology of musculoskeletal pain [IASP Web site]. 2009. Available at: http://www.iasp-pain.org/AM/
Imai Y, Petersen KK, Morch CD, Arendt Nielsen L. Comparing test-retest reliability and magnitude of conditioned pain modulation using different combinations of test and conditioning stimuli. Somatosens Mot Res 2016;33(3-4):169-77. [CrossRef] [PubMed]
Jensen OK. On the Use of Quantitative Sensory Testing to Estimate Central Sensitization in Humans. Comment on Schuttert et al. The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review. J Clin Med 2022;11(7):1982. [CrossRef] [PubMed]
Kälin S, Rausch-Osthoff AK, Bauer CM. What is the effect of sensory discrimination training on chronic low back pain? A systematic review. BMC Musculoskelet Disord 2016;17:143. [CrossRef] [PubMed]
Kennedy DL, Kemp HI, Ridout D, Yarnitsky D, Rice AS. Reliability of conditioned pain modulation: a systematic review. Pain 2016;157(11):2410-9. [CrossRef] [PubMed]
Kılıçaslan HÖ, Genç A, Tuncer S. Central sensitization in osteoarthritic knee pain: A cross-sectional study. Turk J Phys Med Rehabil 2022;69(1):89-96. [CrossRef] [PubMed]
Kosek E, Ordeberg G. Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain 2000;88(1):69-78. [CrossRef] [PubMed]
Leone C, Truini A. The CPM Effect: Functional Assessment of the Diffuse Noxious Inhibitory Control in Humans. J Clin Neurophysiol 2019;36(6):430-6. [CrossRef] [PubMed]
Lim EC, Sterling M, Stone A, Vicenzino B. Central hyperexcitability as measured with nociceptive flexor reflex threshold in chronic musculoskeletal pain: A systematic review. Pain 2011;152(8):1811–20. [CrossRef] [PubMed]
Lim JA, Choi SH, Lee WJ, Jang JH, Moon JY, Kim YC, et al. Cognitive-behavioral therapy for patients with chronic pain: Implications of gender differences in empathy. Medicine (Baltimore) 2018;97(23): e10867. [CrossRef] [PubMed]
Luna D, Hettie G, Pirrotta L, Salmasi V, Hah JM. Real-world long-term outcomes of peripheral nerve stimulation: a prospective observational study. Pain Manag 2025;15(1):37-44. [CrossRef] [PubMed]
Middlebrook N, Heneghan NR, Evans DW, Rushton A, Falla D. Reliability of temporal summation, thermal and pressure pain thresholds in a healthy cohort and musculoskeletal trauma population. PLoS One 2020;15(5):e0233521. [CrossRef] [PubMed]
Neblett R. The central sensitization inventory: A user's manual. J Appl Biobehav Res 2018; 23:e12123. [CrossRef]
Neelapala YVR, Bhagat M, Frey-Law L. Conditioned Pain Modulation in Chronic Low Back Pain: A Systematic Review of Literature. Clin J Pain 2020;36(2):135-41. [CrossRef] [PubMed]
Nijs J, George SZ, Clauw DJ, Fernández-de-Las-Peñas C, Kosek E, Ickmans K, et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. The Lancet Rheumatology 2021; 3.5: e383-e392. [CrossRef] [PubMed]
Pavlakovic G, Petzke F. The role of quantitative sensory testing in the evaluation of musculoskeletal pain conditions. Curr Rheumatol Rep 2010;12(6):455–61. [CrossRef] [PubMed]
Petersen KK, Kilic K, Hertel E, Sejersgaard-Jacobsen TH, Jørgensen MK, Troelsen A, et al. Quantitative sensory testing as an assessment tool to predict the response to standard pain treatment in knee osteoarthritis: a systematic review and meta-analysis. Pain Rep 2023;8(4): e1079. [CrossRef] [PubMed]
Queremel Milani DA, Davis DD. Pain Management Medications. 2023 Jul 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. [PubMed]
Riquelme-Aguado V, Di-Bonaventura S, González-Álvarez ME, Zabarte-Del Campo A, Fernández-Carnero J, Gil-Crujera A, et al. How Does Conditioned Pain Modulation Influence Motor Imagery Processes in Women with Fibromyalgia Syndrome? A Cross-Sectional Study Secondary Analysis. J Clin Med 2024;13(23):7339. [CrossRef] [PubMed]
Rolke R, Baron R, Maier C, Tölle TR, Treede -DR, Beyer A, et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain 2006;123(3):231-43. [CrossRef]
Santiago V, Janal MN, Cook DB, Raphael KG. Temporal Summation and Aftersensations of Second Pain in Women with Myofascial Temporomandibular Disorder Differ by Presence of Temporomandibular Joint Pain. J Pain Res. 2022 Oct 19;15:3275-3286. [CrossRef] [PubMed]
Sielski R, Rief W, Glombiewski JA. Efficacy of Biofeedback in Chronic back Pain: a Meta-Analysis. Int J Behav Med 2017: 24(1): 25–41. [CrossRef] [PubMed]
Tao ZY, Wang PX, Wei SQ, Traub RJ, Li JF, Cao DY. The Role of Descending Pain Modulation in Chronic Primary Pain: Potential Application of Drugs Targeting Serotonergic System. Neural Plast 2019; 2019:1389296. [CrossRef] [PubMed]
Tomašević-Todorović S, Spasojević T. Central Sensitization in Patients with Chronic Musculoskeletal Pain. Acta clinica Croatica 2023;62(Suppl4):102-6. [CrossRef] [PubMed]
Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019;160(1):19-27. [CrossRef] [PubMed]
Trouvin, Anne-Priscille, Nadine Attal, and Serge Perrot. "Assessing central sensitization with quantitative sensory testing in inflammatory rheumatic diseases: a systematic review." Joint Bone Spine 2022; 89(5): 105399. [CrossRef] [PubMed]
Verbrugghe J, Agten A, Stevens S, Vandenabeele F, Roussel N, Verbunt J, et al. High intensity training improves symptoms of central sensitization at six-month follow-up in persons with chronic nonspecific low back pain: Secondary analysis of a randomized controlled trial. Braz J Phys Ther 2023;27(2):100496. [CrossRef] [PubMed]
Yarnitsky D, Granot M, Nahman-Averbuch H, Khamaisi M, Granovsky Y. Conditioned pain modulation predicts duloxetine efficacy in painful diabetic neuropathy. Pain 2012;153(6):1193-8. [CrossRef] [PubMed]
Zeidan F, Vago DR. Mindfulness meditation-based pain relief: a mechanistic account. Ann N Y Acad Sci 2016;1373(1):114-27. [CrossRef] [PubMed]
