Relationship of Pain Quality Descriptors and Quantitative Sensory Testing: Sickle Cell Disease


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Abstract

BackgroundChronic pain in adults with sickle cell disease (SCD) may be the result of altered processing in the central nervous system as indicated by quantitative sensory testing (QST). Sensory pain quality descriptors on the McGill Pain Questionnaire (MPQ) are indicators of typical or altered pain mechanisms but have not been validated with QST-derived classifications.ObjectivesThe specific aim of this study was to identify the sensory pain quality descriptors that are associated with the QST-derived normal or sensitized classifications. We expected to find that sets of sensory pain quality descriptors would discriminate the classifications.MethodA cross-sectional quantitative study of existing data from 186 adults of African ancestry with SCD. Variables included MPQ descriptors, patient demographic data, and QST-derived classifications.ResultsThe participants were classified as central sensitization (n = 33), mixed sensitization (n = 23) and normal sensation. Sensory pain quality descriptors that differed statistically between mixed sensitization and central sensation compared to normal sensitization included: cold (p = .01), and spreading (p=.01). Aching (p = .01) and throbbing (p = .01) differed statistically between central sensitization compared with mixed sensitization and normal sensation. Beating (p = .01) differed statistically between mixed sensitization compared with central sensitization and normal sensation. No set of sensory pain quality descriptors differed statistically between QST classifications.DiscussionOur study is the first to examine the association between MPQ sensory pain quality descriptors and QST-derived classifications in adults with SCD. Our findings provide the basis for the development of an MPQ subscale with potential as a mechanism-based screening tool for neuropathic pain.

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