Establishing abdominal QST reference values for healthy adults and adolescents

Abstract

Debilitating abdominal and pelvic pain conditions are highly prevalent in adults and adolescents. Assessing sensory functioning among people with painful conditions is important in understanding the disease. Reference values for Quantitative Sensory Testing (QST), used to assess sensory perception, are well established for other regions but not the abdomen. The aim of this study was to establish QST reference values for the abdomen in a diverse group of males and female adults and adolescents. In this cross-sectional study, 181 healthy, pain-free males and females from age 12-50 years completed a comprehensive QST battery in upper and lower abdomen and a control site. The QST battery consisted of: Dynamic Mechanical Touch (DMT), Light Touch Detection (LTD), Sharp Prick Detection (SPD), Pressure Pain Threshold (PPT), Temporal Summation of Pain (TSP), Cool and Warmth Detection Thresholds (CDT, WDT), and Cold and Heat Pain Thresholds (CPT, HPT). Participants also answered pain-related questionnaires including the Pain Catastrophizing Scale, 36-Item Short Form Survey, Pain Sensitivity Questionnaire (PSQ). Mean and standard deviation values were calculated for each QST sub-test and separated by age, sex, and body site (upper and lower abdomen, and control site). Results of RMANOVAs indicated that pain sensitivity differed by site and modality, with no consistent pattern indicating one area was generally more sensitive than others. There were also effects of sex with males experienced less sensitivity to pressure and cold pain than females. Self-reported pain sensitivity (PSQ) was associated with greater abdominal sensitivity to punctate, cold, and heat pain. This paper successfully established reference QST values for the upper and lower abdominal sites for healthy, pain-free male and female adolescents and adults which will be critical in understanding somatosensory nervous system function among patients with abdominal and pelvic pain. These data will be critical in understanding nociceptive processing in the abdominal region. Boston Center for Endometriosis/Marriott Family Foundation Investigator Grant Office of Faculty Developtment at Boston Children's Hospital.