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B. Ganatra1, T. Watson1
1University Of Hertfordshire, Physiotherapy, Hatfield, United Kingdom
Background: Sensory hyperalgesia has been associated with the development of chronic pain conditions such as patients with neuropathic pain conditions, whiplash and fibromyalgia. This has been examined using Quantitative sensory testing (QST) within the laboratory environment to quantify the sensory responses to different stimuli. QST studies are useful in predicting poor outcomes with traditional physiotherapy management and provide insight to the pain mechanisms involved. Previous studies focus on the physiological influences such and pain and pathology and it’s influence on the somatosensory profile. Very few studies have examined if biopsychosocial factors have an effect on QST profiles, both within a patient population and a healthy sample. This area is important to investigate as patients with chronic pain conditions in the presence of psychosocial issues tend to have poorer outcomes with traditional physiotherapy and require a holistic care approach.
Purpose: The true spread of responses to QST within the healthy normal group are not fully understood. Many studies examining somatosensory profiles compare the symptomatic group against a ‘healthy’ control group. What is unknown is if psychosocial factors within the healthy population can influence the QST profile. This is particularly important as QST studies are paving the way for both medical and physiotherapy management and it is imperative that the research is enabling optimum making the correct conclusions in order to inform clinical practice. The aim of this study was to explore if depression and anxiety affect somatosensory profiles. This study was unique as identified that there is a psychosocial influence on the presentation of QST profiles and that they present differently between self-reported depression and anxiety scores.
Methods: QST profiles and self-declared anxiety (GAD-7) and depression (PHQ-9) were recorded for 41 healthy participants. As per QST protocol, Participants underwent electrical stimulation testing (EST), pressure pain threshold testing (PPT), heat pain threshold testing (HPT) and cold pain threshold testing (CPT) (using the TSA II) to the right or left elbow all of which were randomised. Each test was repeated 3 times.
Results: Depression and anxiety were positively correlated and statistically significant using the Spearman’s rank test (r=0.67, p=0.01).
Participants were split into high and low scorers for depression and anxiety. The high scoring depression group had higher CPT, EST and PPT scores whereas the high scoring anxiety group had lower CPT, EST and PPT scores.
Participants were split into high and low scorers for depression and anxiety. The high scoring depression group had higher CPT, EST and PPT scores whereas the high scoring anxiety group had lower CPT, EST and PPT scores.
Conclusion(s): This preliminary data demonstrated that somatosensory profiles have a relationship with self-reported anxiety and depression. It is imperative that future research can identify if psychosocial factors can influence and modify somatosensory profiles using QST testing to allow rigorous comparisons to a healthy control group.
Implications: Within a healthy sample somatosensory profiles appear differently in the presence of depression or anxiety. These factors affect an individual’s sensory hyperalgesia.
Funding, acknowledgements: This study was partly funded by the University of Hertfordshire.
Keywords: QST, somatosensory profiles, depression, anxiety.
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: University of Hertfordshire
Committee: HSK
Ethics number: HSK/SF/UH/00089
All authors, affiliations and abstracts have been published as submitted.
