Quantitative sensory testing: effect of site and skin temperature on thermal thresholds

• Published in: Clinical neurophysiology Vol. 111; no. 1; pp. 17 - 22
• Main Authors: Hagander, Louise G, Midani, Hani A, Kuskowski, Michael A, Parry, Gareth J.G
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier B.V 01.01.2000; Elsevier Science
• Subjects: Adult; Algorithms; Biological and medical sciences; Cold Temperature; Female; Foot; Fundamental and applied biological sciences. Psychology; Hand; Hot Temperature; Humans; Male; Middle Aged; Pain Threshold; Quantitative sensory testing; Reference Values; Sensory Thresholds; Site; Skin temperature; Skin Temperature - physiology; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors; Thermal pain; Thermal threshold; Vertebrates: nervous system and sense organs; Wrist; Site; Thermal threshold; Thermal pain; Quantitative sensory testing; Skin temperature; Human; Nociception; Noxious stimulus; Analysis method; Perception threshold; Thermal stimulus; Skin
• ISSN: 1388-2457
• DOI: 10.1016/S1388-2457(99)00192-3

Objective: To determine the effect of different sites and local skin temperature on thermal thresholds. Methods: Cool and warm detection and cold and heat pain thresholds were compared in 46 normal volunteers at the thenar eminence (TE), dorsum of the hand (DH), volar surface of the wrist (VW) and dorsum of the foot (DF). Results: The hand is more sensitive than the foot for cool and warm. TE is more sensitive for warm than DH and VW but the difference is clinically negligible. DH and VW are equally sensitive to warm. TE, DH, and VW are equally sensitive to cool. Inter-individual variance is smallest at TE. Warm and cool thresholds are independent of local skin temperature (range of 27–37°C). TE is less sensitive for cold pain but otherwise the hand and the foot are equally sensitive to thermal pain. Conclusion: Testing of thermal thresholds in normal subjects can be adequately conducted at several sites at the hand, however, TE is preferred given the small inter-individual variability. TE may be preferred for evaluating hyperalgesia to cold given its higher threshold. Warming or cooling of the skin is unnecessary within the range normally encountered in routine clinical evaluation.