Rapid bedside heat-pain ratings are highly correlated with computer-aided QST: a direct comparison of fixed-stimulus intensity rating and CASE IV testing in patients with possible small fiber neuropathy

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Routine clinical use of thermal QST using computer-aided devices is limited because the equipment is expensive and the protocols are time-consuming. Fixed-stimulus intensity rating is fast and can be performed in the context of a bedside examination with relatively inexpensive equipment. We compared heat-pain perception on the foot dorsum, using both techniques, followed by skin biopsy at the same site for epidermal nerve fiber (ENF) density evaluation, in 31 subjects with a clinical diagnosis of possible length-dependent small fiber neuropathy.