QST Study: Predicting Treatment Response in Chronic Pancreatitis Using Quantitative Sensory Testing
Anna Evans Phillips
Summary
Quantitative Sensory Testing (QST) is a novel investigative technique used in other pain conditions to evaluate patterns of chronic pain, and in this study will be used to elucidate pain patterns in patients with Chronic Pancreatitis (CP). QST uses a specific series of standardized stimulations to map the pain system. QST has the potential to change and improve the treatment paradigm for patients with CP and may eventually be able to predict response to invasive CP therapies.
Description
In Chronic Pancreatitis (CP), clinical pain symptoms correlate poorly with pancreatic ductal morphology, response to endoscopic or surgical therapy is unpredictable, and the rationale for invasive therapies is often questioned. Quantitative sensory testing (QST) is a technique used to map the pain system based on the rationale that different neural pathways and networks can be explored using standardized stimulation and simultaneous recording of the evoked pain response by psychophysical and/or objective methods. In this study, the investigators aim to distinguish phenotypes characterized by s…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. Subjects with no pancreatic disease and no abdominal pain, or patients with a diagnosis of functional dyspepsia. * Subjects are 18 years or older in age * Subjects must be able to read and understand the study information. * Personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study. * Subject is willing and able to comply with the scheduled visits, questionnaires, treatment plan, and other study procedures. 2. Suspected CPs Inclusion Criteria * Subjects are 18 years or older…
Interventions
- Diagnostic TestQuantitative Sensory Test 1
Subject will give pain rating (on Visual Analogue Scale (VAS) 0-10) of single as well as multiple stimulation with round-tip non-invasive pin-prick device. Difference is recorded as Temporal Summation Score.
- Diagnostic TestQuantitative Sensory Test 2
Subject will state when they first detect pain and pain detection threshold in response to pressure administration with pressure algometer. Pressure threshold recorded in kilopascals(kP). Stimulation will be repeated in pancreatic and control dermatomes. Subject will then state pain tolerance threshold at same locations. Sensitization will be characterized by ratio of pancreatic vs. control dermatome scores.
- Diagnostic TestQuantitative Sensory Test 3
Subject will apply dominant hand to ice-chilled water bath (36F) for up to 2 minutes. Pain score (VAS 0-10) will be assessed each 10 seconds. Pain tolerance threshold (in kP) will be assessed with algometer on non-dominant thigh before and after water bath to determine change in threshold. Difference in pain tolerance recorded as Conditioned Pain Modulation Score.
Locations (2)
- Johns Hopkins Medical InstitutionsBaltimore, Maryland
- University of Pittsburgh Medical CenterPittsburgh, Pennsylvania