Thermal Sensory Testing Research Articles

Mechanical and Thermal Sensory Testing in Normal Chondrodystrophoid Dogs and Dogs with Spinal Cord Injury caused by Thoracolumbar Intervertebral Disc Herniations.

BackgroundIntervertebral disc herniation is a common cause of spinal cord injury (SCI) causing paralysis and sensory loss. Little quantitative information is available on the loss and recovery of sensation in dogs with SCI.ObjectivesTo determine whether quantitative sensory testing (QST) can be used to establish thermal and mechanical sensory thresholds in chrondrodystrophoid dogs and compare thresholds among normal dogs and dogs with different grades of SCI.AnimalsThirty‐three client‐owned chondrodystrophoid dogs: 15 normal and 18 SCI dogs.MethodsThermal testing was performed by placing a hot (49°C) and cold (5°C) probe on the dorsal metatarsus and mechanical thresholds were tested using calibrated forceps to apply force to the lateral digit. Stimuli were applied until acknowledged, and response rate, latency, and force applied to response were recorded. Test‐retest repeatability was determined by calculating intraclass correlation coefficients. Response rates were compared using logistic regression and thresholds were compared using Kaplan–Meier Survival curves.ResultsTesting was feasible with moderate repeatability. Thresholds and response rates were significantly different between normal and SCI dogs for all modalities (P < .001). When dogs were grouped by their clinical grade, each grade was significantly different from normal dogs, and cold stimuli differentiated among all grades.Conclusion and clinical importanceSensory thresholds can be measured reliably in chondrodystrophoid dogs and are altered by SCI. The differences in sensation among neurologic grades indicate that these techniques can be used to further characterize recovery of SCI dogs.

Comparison of thermal and mechanical quantitative sensory testing in client-owned dogs with chronic naturally occurring pain and normal dogs

Detecting dogs with central sensitization (CS) secondary to chronic pain is hampered by the current inability to measure this condition. The current study aimed to use quantitative sensory testing (QST) to measure (CS) in normal dogs and dogs with painful degenerative joint disease (DJD). It was hypothesized that QST would differ between these two groups of animals. Mechanical and thermal sensory thresholds obtained in animals with DJD-associated pain on two time points 28 days apart were compared with those of normal dogs. Values of sensory thresholds in DJD dogs obtained 28 days after the first evaluation were significantly lower than the results on the first day of evaluation but no differences were found when these results were compared with those of normal dogs. In conclusion, whether QST is different between dogs with chronic pain and normal dogs needs further investigation using a larger group of animals and age, weight and sex matched groups.

Sickle Cell Disease Patients Show Sensitization of Myelinated Sensory Nerve Fibers

There is increasing evidence that many patients with sickle cell disease (SCD) develop chronic pain in addition to experiencing acute pain secondary to vaso-occlusive episodes (VOE). Those patients who develop chronic pain often exhibit features suggestive of neuropathic processes such as allodynia and pain "shooting" or "tingling" in character. Using electrophysiologic techniques in ex-vivo nerve-skin preparations and nocifensive behavior studies in sickle cell mouse models, we and others have shown that SCD is associated with sensitization of light touch cutaneous sensory fibers, and decreased threshold in response to 2000Hz and 250 Hz electrical sine wave stimulation. These findings are indicative of Aβ and Ad fibers sensitization and in turn compatible with neuropathic process.We hypothesized that the same phenomena of nerve fiber sensitization in the mouse model would be observed in SCD patients. This hypothesis was tested using an experimental paradigm with sine-wave electrical stimulation delivered at three different frequencies: 2000, 250, and 5 Hz, which preferentially stimulate Aβ, Ad, and C fibers, respectively. Thermal and mechanical sensory testing was also performed. After IRB approval, SCD subjects with high (≥ than 3 ER visits or admissions for VOEs per year) or low (< 2 ER visits or admissions per year) pain frequency, and age- and sex-matched African-American healthy controls were recruited at baseline states during routine clinic visits. After informed consent (and/or assent) was obtained, patients underwent quantitative sensory testing (QST) that included heat and cold perception and tolerance (with a TSA II-Sensory Analyzer), mechanical (using a Wagner FDIX Force One) and current perception and pain tolerance thresholds (using the Neurometer).We enrolled 19 SCD subjects with high and 4 with low pain frequency (total 23 SCD participants), and 11 African-American non-SCD subjects who tolerated and completed all QSTs. As there was no difference between QST responses in patients with high and low pain frequency, these two groups were combined as the SCD group. We found that SCD subjects had significantly decreased cold tolerance threshold (p=0.034) and a trend towards lower thresholds for cold perception and heat tolerance, which is in concert with previously reported findings. Expanding upon these findings, SCD patients had a significantly reduced pain tolerance threshold in response to 2000 Hz stimulation (p=0.005), which preferentially stimulates Aβ fibers (see figure). These results suggest that adolescents with SCD have sensitization of myelinated Aβ fibers. Interrogation of the Ad and C fibers with 250 and 5 Hz stimulation, respectively, revealed no significant differences in tolerance thresholds among the groups, however SCD patients showed a trend toward lower thresholds in both frequencies (see figure). Combined, these findings support the use of sine-wave stimulation on the evaluation of pain phenotype in SCD and the notion that SCD subjects may have neuropathic processes contributing to their pain phenotype. TableDemographics, thermal and mechanical sensory testing in SCD and control subjects.VariableSCD (n=23)Control (n=11)Age (years)16 (15-18.8)19 (14-21)Male (%)3 (30%)11 (48%)Cold Perception (°C)29.8 (28.5-30.5)30.4 (29.9-30.9)Cold Tolerance (°C)8.5 (2.0-17.0) *0.9 (0.0-6.9)Heat Perception (°C)34.4 (33.5-35.2) *33.6 (33.2-34.1)Heat Tolerance (°C)48.9 (47.5-49.8)50.0 (45.3-50.1)Mechanical Tolerance (lbF)7.7 (5.9-9.7)9.5 (7.7-10.8)*p < 0.05. Values are shown as median and interquartile range. SCD subjects reached cold tolerance and heat perception at significantly higher temperatures as compared to controls; p=0.034 and p= 0.035, respectively. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Orofacial Thermal Quantitative Sensory Testing (QST): A Study of Healthy Korean Women and Sex Difference

Purpose: Thermal sensory test as an essential part of quantitative sensory testing (QST) has been recognized as a useful tool in the evaluation of the trigeminal nerve function. Normative data in the orofacial region have been reported but the data on differences in the test site, sex and ethnicity are still insufficient. Thus, this study aimed to investigate the normal range of orofacial thermal QST data in the healthy Korean women, and assess sex difference of thermal perception in the orofacial regions. Methods: Thermal QST was conducted on 20 healthy women participants (mean age, 26.4 years; range, 21 to 34 years). The thermal thresholds (cold detection threshold, CDT; warm detection threshold, WDT; cold pain threshold, CPT; and heat pain threshold, HPT) were measured bilaterally at the 5 trigeminal sites (the forehead, cheek, mentum, lower lip and tongue tip). The normative thermal thresholds of women in the orofacial region were evaluated using one-way ANOVA and compared with the previously reported data from age- and site-matched 30 healthy men (mean age, 26.1 years; range, 23 to 32 years) using two-way ANOVA. One experienced operator performed the tests of both sexes and all tests were done in the same condition except the time variability. Results: Women showed significant site differences for the CDT (p<0.001), WDT (p<0.001), and HPT (p=0.047) in the orofacial region. The CDT (p<0.001) and the CPT (p=0.007) presented significant sex difference unlike the WDT and the HPT. Conclusions: The thermal sensory evaluation in the orofacial region should be considered in the context of site and sex and the normative data in this study could be useful for assessment of the sensory abnormalities in the clinical setting.

Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome--a probable neuropathic pain condition?

BackgroundTo explore the hypothesis that burning mouth syndrome (BMS) probably is a neuropathic pain condition, thermal and mechanical sensory and pain thresholds were tested and compared with age- and gender-matched control participants using a standardized battery of psychophysical techniques.MethodsTwenty-five BMS patients (men: 8, women: 17, age: 49.5 ± 11.4 years) and 19 age- and gender-matched healthy control participants were included. The cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT), in accordance with the German Network of Neuropathic Pain guidelines, were measured at the following four sites: the dorsum of the left hand (hand), the skin at the mental foramen (chin), on the tip of the tongue (tongue), and the mucosa of the lower lip (lip). Statistical analysis was performed using ANOVA with repeated measures to compare the means within and between groups. Furthermore, Z-score profiles were generated, and exploratory correlation analyses between QST and clinical variables were performed. Two-tailed tests with a significance level of 5 % were used throughout.ResultsCDTs (P < 0.02) were significantly lower (less sensitivity) and HPTs (P < 0.001) were significantly higher (less sensitivity) at the tongue and lip in BMS patients compared to control participants. WDT (P = 0.007) was also significantly higher at the tongue in BMS patients compared to control subjects . There were no significant differences in MDT and MPT between the BMS patients and healthy subjects at any of the four test sites. Z-scores showed that significant loss of function can be identified for CDT (Z-scores = −0.9±1.1) and HPT (Z-scores = 1.5±0.4). There were no significant correlations between QST and clinical variables (pain intensity, duration, depressions scores).ConclusionBMS patients had a significant loss of thermal function but not mechanical function, supporting the hypothesis that BMS may be a probable neuropathic pain condition. Further studies including e.g. electrophysiological or imaging techniques are needed to clarify the underlying mechanisms of BMS.

Novel phase II clinical trial design approaches.

Novel phase II clinical trial design approaches.

Degree of Skin Denervation and Its Correlation to Objective Thermal Sensory Test in Leprosy Patients

BackgroundLeprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST). Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods.Methodology/Principal FindingsThis work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain). The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6) and 80.8% (SD = 24.9), respectively.Conclusions/SignificanceWe observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its diagnostic applicability, particularly in selected cases with only discrete sensory impairment, patients unable to perform the sensory test and especially those with nonspecific histopathological finds.

Quantitative thermal sensory testing and sympathetic skin response in primary Restless legs syndrome - A prospective study on 57 Indian patients

Patients with restless leg syndrome present with sensory symptoms similar to peripheral neuropathy. While there is evidence of abnormalities of dopaminergic pathways, the peripheral nervous system has been studied infrequently. We studied conventional nerve conduction studies, quantitative thermal sensory testing and sympathetic skin response in 57 patients with primary restless leg syndrome. Almost two third patients demonstrated abnormalities in the detailed testing of the peripheral nervous system. Sbtle abnormalities of the peripheral nervous system may be more common than previously believed.

Natural history of sensory function after herpes zoster

The natural history of sensory function in the first 6 months after herpes zoster (HZ) was determined in a cohort of 94 subjects at elevated risk for developing post-herpetic neuralgia (PHN). All four visits included ratings of pain and sensory symptoms, mapping areas of altered sensation and allodynia, and quantitative thermal and mechanical sensory testing. The last three visits included the capsaicin response test. Sensory thresholds in distant control skin were stable. Mirror-image skin was persistently hyperesthetic to warming and mechanical stimuli and hyperalgesic to heat compared to distant control skin. HZ skin showed deficits in all thermal modalities. Sensory recovery was limited and selective. Allodynia area and severity, hyperalgesia to von Frey hair, and cold detection threshold improved, but deficits to warmth and heat pain did not. Capsaicin on HZ skin significantly aggravated pain and allodynia in the majority of subjects at 6–8 weeks after HZ onset. At study entry, eventual PHN subjects had significantly more impairment in detecting warmth and cold, a larger area of altered sensation, a larger area of allodynia, and more severe allodynia. The results support the study hypothesis that severity of initial injury predicts PHN, especially impaired cold sensation in HZ skin. The hypothesis that PHN develops because of a failure to recover normal neural function was not supported. Sensory recovery proceeded at the same rate in eventual pain-free and eventual PHN subjects and is not a requirement for pain resolution. Early interventions that reduce neural injury or enhance recovery should be of benefit.

Sensory Perception Thresholds in Men With Chronic Pelvic Pain Syndrome

To compare sensory thresholds in different nerve-fiber types in men with chronic pelvic pain syndrome (CPPS) and healthy controls, using thermal sensory testing and measuring current perception thresholds (CPT). We enrolled 22 men with CPPS and 20 healthy control participants. We determined the thermal sensory perception thresholds of C and Adelta nerve fibers on the perineum and left posterior thigh. To test CPT, we used sine wave electrical stimulation at 5, 250, and 2000 Hz, resulting in the selective depolarization of small unmyelinated C fibers, small myelinated Adelta, and large myelinated Abeta fibers, respectively. We bilaterally tested the hypothenar surface of the palms, medial parts of soles, midshaft of penis, and 1 site in the midperineum, for a total of 7 sites. The mean age of men with CPPS was similar to that of controls [42.8 (standard deviation, 9.4) and 40.4 (standard deviation, 13.2) years, respectively, P = .548]. There was no significant difference between the 2 groups for thermal perception thresholds in both the perineum and left thigh (P >.05). There was also no difference between the 2 groups for CPT values of all 3 frequencies of stimuli in each area tested (P >.05 for all comparisons). The absence of sensory threshold differences between men with CPPS and controls, with either thermal stimulation of C and Adelta fiber afferents or electrical stimulation of C, Adelta, and Abeta fiber afferents, discounts the existence of a peripheral neuropathy as a cause for pain in men with CPPS.

Quantitative Sensory Testing and Mapping

Despite a growing interest in neuropathic pain, neurologists and pain specialists do not have a standard, validated, office examination for the evaluation of neuropathic pain signs to complement the neurologic, musculoskeletal, and general physical examinations. An office neuropathic pain examination focused on quantifying sensory features of neuropathic pain, ranging from deficits to allodynia and hyperalgesia, and evoked by a physiologically representative array of stimuli, will be an essential tool to monitor treatment effectiveness and for clinical investigation into the mechanisms and management of neuropathic pain. Such an examination should include mapping of areas of stimulus-evoked neuropathic pain and standardized, reproducible quantitative sensory testing (QST) of tactile, punctuate, pressure, and thermal modalities. We review quantitative sensory testing methodology in general and specific tests for the evaluation of neuropathic pain phenomena. Numerous quantitative sensory testing techniques for dynamic mechanical, pressure, vibration, and thermal sensory testing and mapping have been described. We propose a comprehensive neuropathic pain evaluation protocol that is based upon these available techniques. A comprehensive neuropathic pain evaluation protocol is essential for further advancement of clinical research in neuropathic pain. A protocol that uses tools readily available in clinical practice, when established and validated, can be used widely and thus accelerate data collection for clinical research and increase clinical awareness of the features of neuropathic pain.

Pain, Psychosocial, Sexual, and Psychophysical Characteristics of Women with Primary vs. Secondary Provoked Vestibulodynia

Women with provoked vestibulodynia (PVD), a common cause of dyspareunia, are typically considered a homogeneous group. However, research suggests that differences on some factors (e.g., medical history, pain characteristics, psychological functioning, treatment response) exist based upon whether the pain was present at first intercourse (primary PVD: PVD1) or developed at some later point (secondary PVD: PVD2). The purpose of this study was to examine differences in demographic variables, pain characteristics, psychosocial and psychosexual adjustment, and pain sensitivity between women with PVD1 and PVD2. Twenty-six women suffering from PVD (13 with PVD1 and 13 with PVD2) completed a screening assessment, a standardized gynecological examination, an interview, questionnaires, and a quantitative sensory testing session. These included pain ratings during the gynecological examination and interview, scores on measures of psychosocial/sexual functioning (e.g., Short Form-36 [SF-36] Health Survey, Female Sexual Function Index), and thresholds and pain ratings during thermal sensory testing over the dominant forearm and vulvar vestibule. The women with PVD1 were more likely to be nulliparous, but they were not significantly different from the women with PVD2 on other demographic variables or in their pain ratings during the gynecological examination. The women with PVD1 reported lower levels of social and emotional functioning and heightened anxiety surrounding body exposure during sexual activity, and they also displayed lower heat pain tolerance over the forearm and lower heat detection and pain thresholds at the vulvar vestibule than the women with PVD2. The findings from this study support previous research indicating that women with PVD1 and PVD2 differ in a number of domains. Further research is needed to confirm and elaborate on these findings.

P082 Thermal sensory testing (Thermotest) in polyneuropathies

P082 Thermal sensory testing (Thermotest) in polyneuropathies

Early Diagnosis of Neuropathy in Leprosy—Comparing Diagnostic Tests in a Large Prospective Study (the INFIR Cohort Study)

BackgroundLeprosy is the most frequent treatable neuromuscular disease. Yet, every year, thousands of patients develop permanent peripheral nerve damage as a result of leprosy. Since early detection and treatment of neuropathy in leprosy has strong preventive potential, we conducted a cohort study to determine which test detects this neuropathy earliest.Methods and FindingsOne hundred and eighty-eight multibacillary (MB) leprosy patients were selected from a cohort of 303 and followed for 2 years after diagnosis. Nerve function was evaluated at each visit using nerve conduction (NC), quantitative thermal sensory testing and vibrometry, dynamometry, monofilament testing (MFT), and voluntary muscle testing (VMT). Study outcomes were sensory and motor impairment detected by MFT or VMT. Seventy-four of 188 patients (39%) had a reaction, neuritis, or new nerve function impairment (NFI) event during a 2-year follow-up. Sub-clinical neuropathy was extensive (20%–50%), even in patients who did not develop an outcome event. Sensory nerve action potential (SNAP) amplitudes, compound motor action potential (CMAP) velocities, and warm detection thresholds (WDT) were most frequently affected, with SNAP impairment frequencies ranging from 30% (median) to 69% (sural). Velocity was impaired in up to 43% of motor nerves. WDTs were more frequently affected than cold detection thresholds (29% versus 13%, ulnar nerve). Impairment of SNC and warm perception often preceded deterioration in MF or VMT scores by 12 weeks or more.ConclusionsA large proportion of leprosy patients have subclinical neuropathy that was not evident when only MFT and VMT were used. SNC was the most frequently and earliest affected test, closely followed by WDT. They are promising tests for improving early detection of neuropathy, as they often became abnormal 12 weeks or more before an abnormal monofilament test. Changes in MFT and VMT score mirrored changes in neurophysiology, confirming their validity as screening tests.

Enhanced skin blood flow and sensitivity to noxious heat stimuli in papulopustular rosacea

Although patients with rosacea often complain of increased skin sensitivity, there has been no quantitative sensory testing of this phenomenon. Furthermore, cutaneous blood flow in these patients has not been assessed using state-of-the-art laser Doppler imaging (LDI). To assess heat pain thresholds and skin blood flow using quantitative thermal sensory testing and LDI in patients with untreated rosacea. Of the total 24 subjects enrolled, 8 had papulopustular rosacea (PPR), 8 had erythematotelangiectatic rosacea (ETR) and 8 were control subjects. Subjective burning perception, heat pain threshold, skin blood flow, and skin temperature was assessed in all subjects. In the ETR and PPR groups, two areas were compared: affected and nonaffected. Heat pain thresholds of areas affected by rosacea were lower than those of nonaffected areas. In addition, subjective burning perception was increased in rosacea patients when compared with control subjects. Although PPR-affected skin had elevated skin blood flow when compared with nonaffected skin, this was not significant for ETR-affected skin. The small number of subjects enrolled was the main limitation. This study showed enhanced sensitivity to noxious heat stimuli in rosacea-affected skin, which was more prominent in the PPR group.

O0018 Quantitative thermal sensory testing and sympathetic skin response in primary restless legs syndrome–aprospective study of 57 Indian patients

O0018 Quantitative thermal sensory testing and sympathetic skin response in primary restless legs syndrome–aprospective study of 57 Indian patients

Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy)

CRPS-I consists of post-traumatic limb pain and autonomic abnormalities that continue despite apparent healing of inciting injuries. The cause of symptoms is unknown and objective findings are few, making diagnosis and treatment controversial, and research difficult. We tested the hypotheses that CRPS-I is caused by persistent minimal distal nerve injury (MDNI), specifically distal degeneration of small-diameter axons. These subserve pain and autonomic function. We studied 18 adults with IASP-defined CRPS-I affecting their arms or legs. We studied three sites on subjects’ CRPS-affected and matching contralateral limb; the CRPS-affected site, and nearby unaffected ipsilateral and matching contralateral control sites. We performed quantitative mechanical and thermal sensory testing (QST) followed by quantitation of epidermal neurite densities within PGP9.5-immunolabeled skin biopsies. Seven adults with chronic leg pain, edema, disuse, and prior surgeries from trauma or osteoarthritis provided symptom-matched controls. CRPS-I subjects had representative histories and symptoms. Medical procedures were unexpectedly frequently associated with CRPS onset. QST revealed mechanical allodynia ( P < 0.03) and heat-pain hyperalgesia ( P < 0.04) at the CRPS-affected site. Axonal densities were highly correlated between subjects’ ipsilateral and contralateral control sites ( r = 0.97), but were diminished at the CRPS-affected sites of 17/18 subjects, on average by 29% ( P < 0.001). Overall, control subjects had no painful-site neurite reductions ( P = 1.00), suggesting that pain, disuse, or prior surgeries alone do not explain CRPS-associated neurite losses. These results support the hypothesis that CRPS-I is specifically associated with post-traumatic focal MDNI affecting nociceptive small-fibers. This type of nerve injury will remain undetected in most clinical settings.

Quantitative thermal sensory testing — value of testing for both cold and warm sensation detection in evaluation of small fiber neuropathy

Objective: Small fiber neuropathy is a common neurological disorder, often missed or ignored by physicians, since examination and routine nerve conduction studies are usually normal in this condition. Many methods including quantitative thermal sensory testing are currently being used for early detection of this condition, so as to enable timely investigation and treatment. This study was conducted to assess the yield of quantitative thermal sensory testing in diagnosis of small fiber neuropathy. Material and methods: We included patients presenting with history suggestive of positive and/or negative sensory symptoms, with normal examination findings, clinically suggestive of small fiber neuropathy, with normal or minimally abnormal routine nerve conduction studies. These patients were subjected to quantitative thermal sensory testing using a Medoc TSA-II Neurosensory analyser at two sites and for two modalities. QST data were compared with those in 120 normal healthy controls. Results: Twenty-five patients (16 males, 9 females) with mean age 46.8 ± 16.6 years (range: 21–75 years) were included in the study. The mean duration of symptoms was 1.6 ± 1.6 years (range: 3 months–6 years). Eighteen patients (72%) had abnormal thresholds in at least one modality. Thermal thresholds were normal in 7 out of the 25 patients. Conclusion: This study demonstrates that quantitative thermal sensory testing is a fairly sensitive method for detection of small fiber neuropathy especially in patients with normal routine nerve conduction studies.

Relationship between oral sensory thresholds and depressive moods.

The aims were to compare the sensory thresholds on the tip of the tongue with on the dorsum of the hand, and to investigate the relationship between the sensory threshold and depressive mood with volunteers whose psychological conditions were normal. Fifty-five subjects (28 women, 27 men) took psychiatric structured diagnostic interview and Self-rating Depression Scale (SDS). In the next step, the quantitative sensory tests (light touch sensation and thermal sensory test) were carried out on the tongue and the hand. Then we investigated the relationship between depressive moods and sensory thresholds on the tongue and the hand using logistic regression model. The sensory thresholds on the tip of the tongues were significantly different from those on the dorsum of the hands. Only on tongue tip, increment of SDS had relation to the thresholds of innoxious thermal stimulation (OR=0.152, 95% CI. 0.049-0.478) and noxious heat stimulation (OR=0.352, 95% CI. 0.169-0.734). This finding might support for the idea that depressive mood had closer association with the tongue of the orofacial areas than the dorsum of the hand.

MULTIDISCIPLINARY PAIN ABSTRACTS: 21 . Neurology (21)

The authors evaluated men with and without chronic pelvic pain syndrome (CPPS) to determine if there were differences between the two groups in their responses to noxious heat stimuli. Sixty‐six healthy men without CPPS and 36 men with a history of CPPS were recruited for the study. Thermal sensory tests were conducted with a small thermode programmed to deliver two series of four rapid bursts of noxious heat stimuli to the perineum and the anterior thigh. The subjects reported sensation on a computerized visual analog scale (COVAS) with a manual sliding lever. The average peak COVAS values and time to peak values from thigh and perineum of each series of thermal bursts were compared between CPPS and controls. The mean pain score on questionnaires was 9.7 (4 or greater indicating significant pain). The mean urinary score was 4.7 (range 0 to 10) and the mean quality of life impact score was 7.3 (range 3 to 13). There was no difference between groups in the peak COVAS value on the thigh. The authors concluded that men with CPPS have altered heat sensation/pain sensitization in the perineum compared to controls. This finding is another that supports the resemblance of CPPS to other chronic pain syndromes and may help explain why CPPS is often refractory to treatment. Further investigations into male CPPS should focus on the mechanisms inducing and maintaining pain in an effort to treat this condition effectively.