Clinical and electrophysiologic correlates of quantitative sensory testing in patients with incomplete spinal cord injury.
OBJECTIVE
To determine the degree of association among indices of preserved sensation derived from quantitative sensory testing (QST), somatosensory evoked potentials (SEPs), and the clinical characteristics of patients with spinal cord injury (SCI).


METHODS
A controlled correlational study of diverse measures of preserved sensory function.


METHODS
Regional SCI rehabilitation center in Ontario, Canada.


METHODS
Thirty-three patients with incomplete SCI and 14 able-bodied controls.


METHODS
Not applicable.


METHODS
QST measures of perceptual threshold for temperature and vibration, American Spinal Injury Association sensory scores (light touch, pinprick), and tibial nerve SEPs.


RESULTS
There was a low degree of association (kappa) between QST results and sensory scores (|kappa|=.05-.44). QST measures yielded greater numbers of patients with SCI being classified as impaired, suggesting a greater sensitivity of QST to detect more subtle sensory deficits. QST measures of vibration threshold generally corresponded to the patients' SEP recordings. QST measures of modalities conveyed within the same tract were significantly (P<.05) correlated (|r|=.46-.84) in patients with SCI, but not in controls, whereas those modalities mediated by different pathways had lower and generally nonsignificant correlations (|r|=.05-.44) in both patients and controls.


CONCLUSIONS
The low degree of association between QST measures and sensory scores is likely attributable to measurement limitations of both assessments, as well as various neuroanatomic and neuropathologic factors. QST provides more sensitive detection of preserved sensory function than does standard clinical examination in patients with incomplete SCI.
Hayes
Keith C
KC
Department of Physical Medicine & Rehabilitation, Parkwood Hospital Site, St. Joseph's Health Care, 801 Commissioners Road E, London, Ontario N6C 5J1, Canada. kchayes@uwo.ca
Wolfe
Dalton L
DL
Hsieh
Jane T
JT
Potter
Patrick J
PJ
Krassioukov
Andrei
A
Durham
Carmen E
CE
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003080:Cold Temperature; D004568:Electrodiagnosis / Q000379:methods* / Q000592:standards; D004594:Electrophysiology; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D012720:Severity of Illness Index; D020886:Somatosensory Disorders / Q000145:classification / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors; D014110:Touch; D014732:Vibration