Cargando…
The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking
OBJECTIVE: Standard nerve excitability testing (NET) predominantly assesses Aα- and Aβ-fiber function, but a method examining small afferents would be of great interest in pain studies. Here, we examined the properties of a novel perception threshold tracking (PTT) method that preferentially activat...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172996/ https://www.ncbi.nlm.nih.gov/pubmed/37181417 http://dx.doi.org/10.1016/j.cnp.2023.03.003 |
_version_ | 1785039729928962048 |
---|---|
author | Pia, Hossein Nochi, Zahra Kristensen, Alexander Gramm Pelz, Bernhard Goetz, Marcus Hoeink, Jan-Niclas Blockeel, Anthony James Mouraux, André Truini, Andrea Finnerup, Nanna Brix Phillips, Keith Geoffrey Treede, Rolf-Detlef Tankisi, Hatice |
author_facet | Pia, Hossein Nochi, Zahra Kristensen, Alexander Gramm Pelz, Bernhard Goetz, Marcus Hoeink, Jan-Niclas Blockeel, Anthony James Mouraux, André Truini, Andrea Finnerup, Nanna Brix Phillips, Keith Geoffrey Treede, Rolf-Detlef Tankisi, Hatice |
author_sort | Pia, Hossein |
collection | PubMed |
description | OBJECTIVE: Standard nerve excitability testing (NET) predominantly assesses Aα- and Aβ-fiber function, but a method examining small afferents would be of great interest in pain studies. Here, we examined the properties of a novel perception threshold tracking (PTT) method that preferentially activates Aδ-fibers using weak currents delivered by a novel multipin electrode and compared its reliability with NET. METHODS: Eighteen healthy subjects (mean age:34.06 ± 2.0) were examined three times with motor and sensory NET and PTT in morning and afternoon sessions on the same day (intra-day reliability) and after a week (inter-day reliability). NET was performed on the median nerve, while PTT stimuli were delivered through a multipin electrode located on the forearm. During PTT, subjects indicated stimulus perception via a button press and the intensity of the current was automatically increased or decreased accordingly by Qtrac software. This allowed changes in the perception threshold to be tracked during strength-duration time constant (SDTC) and threshold electrotonus protocols. RESULTS: The coefficient of variation (CoV) and interclass coefficient of variation (ICC) showed good–excellent reliability for most NET parameters. PTT showed poor reliability for both SDTC and threshold electrotonus parameters. There was a significant correlation between large (sensory NET) and small (PTT) fiber SDTC when all sessions were pooled (r = 0.29, p = 0.03). CONCLUSIONS: Threshold tracking technique can be applied directly to small fibers via a psychophysical readout, but with the current technique, the reliability is poor. SIGNIFICANCE: Further studies are needed to examine whether Aβ-fiber SDTC may be a surrogate biomarker for peripheral nociceptive signalling. |
format | Online Article Text |
id | pubmed-10172996 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-101729962023-05-12 The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking Pia, Hossein Nochi, Zahra Kristensen, Alexander Gramm Pelz, Bernhard Goetz, Marcus Hoeink, Jan-Niclas Blockeel, Anthony James Mouraux, André Truini, Andrea Finnerup, Nanna Brix Phillips, Keith Geoffrey Treede, Rolf-Detlef Tankisi, Hatice Clin Neurophysiol Pract Research Paper OBJECTIVE: Standard nerve excitability testing (NET) predominantly assesses Aα- and Aβ-fiber function, but a method examining small afferents would be of great interest in pain studies. Here, we examined the properties of a novel perception threshold tracking (PTT) method that preferentially activates Aδ-fibers using weak currents delivered by a novel multipin electrode and compared its reliability with NET. METHODS: Eighteen healthy subjects (mean age:34.06 ± 2.0) were examined three times with motor and sensory NET and PTT in morning and afternoon sessions on the same day (intra-day reliability) and after a week (inter-day reliability). NET was performed on the median nerve, while PTT stimuli were delivered through a multipin electrode located on the forearm. During PTT, subjects indicated stimulus perception via a button press and the intensity of the current was automatically increased or decreased accordingly by Qtrac software. This allowed changes in the perception threshold to be tracked during strength-duration time constant (SDTC) and threshold electrotonus protocols. RESULTS: The coefficient of variation (CoV) and interclass coefficient of variation (ICC) showed good–excellent reliability for most NET parameters. PTT showed poor reliability for both SDTC and threshold electrotonus parameters. There was a significant correlation between large (sensory NET) and small (PTT) fiber SDTC when all sessions were pooled (r = 0.29, p = 0.03). CONCLUSIONS: Threshold tracking technique can be applied directly to small fibers via a psychophysical readout, but with the current technique, the reliability is poor. SIGNIFICANCE: Further studies are needed to examine whether Aβ-fiber SDTC may be a surrogate biomarker for peripheral nociceptive signalling. Elsevier 2023-03-30 /pmc/articles/PMC10172996/ /pubmed/37181417 http://dx.doi.org/10.1016/j.cnp.2023.03.003 Text en © 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Pia, Hossein Nochi, Zahra Kristensen, Alexander Gramm Pelz, Bernhard Goetz, Marcus Hoeink, Jan-Niclas Blockeel, Anthony James Mouraux, André Truini, Andrea Finnerup, Nanna Brix Phillips, Keith Geoffrey Treede, Rolf-Detlef Tankisi, Hatice The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title | The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title_full | The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title_fullStr | The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title_full_unstemmed | The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title_short | The test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
title_sort | test–retest reliability of large and small fiber nerve excitability testing with threshold tracking |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172996/ https://www.ncbi.nlm.nih.gov/pubmed/37181417 http://dx.doi.org/10.1016/j.cnp.2023.03.003 |
work_keys_str_mv | AT piahossein thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT nochizahra thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT kristensenalexandergramm thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT pelzbernhard thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT goetzmarcus thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT hoeinkjanniclas thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT blockeelanthonyjames thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT mourauxandre thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT truiniandrea thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT finnerupnannabrix thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT phillipskeithgeoffrey thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT treederolfdetlef thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT tankisihatice thetestretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT piahossein testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT nochizahra testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT kristensenalexandergramm testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT pelzbernhard testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT goetzmarcus testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT hoeinkjanniclas testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT blockeelanthonyjames testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT mourauxandre testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT truiniandrea testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT finnerupnannabrix testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT phillipskeithgeoffrey testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT treederolfdetlef testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking AT tankisihatice testretestreliabilityoflargeandsmallfibernerveexcitabilitytestingwiththresholdtracking |