title: Determinants for Quantitative Sensory Testing and the Association with Chronic Musculoskeletal Pain in the General Elderly Population.
abstract: Chronic musculoskeletal pain is accompanied by central sensitization, which can be determined with quantitative sensory testing (QST). In this study, we aim to investigate whether central sensitization, as measured by thermal QST, is detectable in community-dwelling elderly individuals suffering from self-reported chronic pain and identify determinants influencing thermal QST measurement analyses and interpretation.
  
  
  
  In 3,936 participants of the Rotterdam Study, cold and warmth sensitivity and heat pain thresholds were determined using the thermo-sensory analyzer TSA II (Medoc Advanced Medical Systems, Durham, NC, U.S.A.). Using Cox regression, associations were studied with chronic pain and potential determinants (body mass index [BMI], reaction speed, systolic and diastolic blood pressure, skin color, skin temperature, seasonal influence, depression, anxiety, atopic eczema, age at menarche, years since menopause, hormone replacement therapy (HRT) use during menopause, and reproductive lifespan).
  
  
  
  In addition to the effect of age and gender on thermal sensitivity, darker skin color and the presence of atopic eczema were associated with higher sensitivity for heat pain. Cold sensitivity and warmth sensitivity thresholds were both influenced by BMI, reaction speed, skin temperature, season, depression, dark skin color, years since menopause, and reproductive lifespan. The presence of chronic pain was associated with 0.2 degrees lower heat pain threshold in all participants, and 0.3 degrees lower in individuals with chronic pain in more than 2 sites.
  
  
  
  Higher sensitivity for heat pain, one feature of central sensitization, is present in community-dwelling elderly with chronic pain. Additional determinants should be considered when analyzing and interpreting QST measurements.
authors.affiliation: Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands.|Department of Anesthesiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: de Kruijf
authors.affiliation: Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marjolein J
authors.initials: MJ
authors.lastname: Peters
authors.affiliation: Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Leonie
authors.initials: L
authors.lastname: C Jacobs
authors.affiliation: Department of Psychiatry, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.affiliation: Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Tamar
authors.initials: T
authors.lastname: Nijsten
authors.affiliation: Department of Epidemiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Andre G
authors.initials: AG
authors.lastname: Uitterlinden
authors.affiliation: Department of Anesthesiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Frank J P M
authors.initials: FJ
authors.lastname: Huygen
authors.affiliation: Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
authors.forename: Joyce B J
authors.initials: JB
authors.lastname: van Meurs
mesh_terms: D000368:Aged; D059350:Chronic Pain; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology
keywords: QST; central sensitization; chronic pain; elderly population; musculoskeletal pain; quantitative sensory testing; thermal sensitivity thresholds