Background & Aims

Temporal summation of pain (TSP) is a human proxy for wind-up of dorsal horn
neurons as assessed in animals. The common paradigm for eliciting TSP is evoked by
repetitive nociceptive stimuli of equal intensity. Various stimulation and assessment
protocols have been used. This scoping review aims to provide insight into key
elements of TSP stimulation and assessment: modality, instruments, test location,
familiarization, train characteristics, and calculations

Methods

PubMed, Embase, and Ebsco/CINAHL were searched for studies that measured TSP in adults with
musculoskeletal conditions and healthy people. Four-hundred-and-six studies were included.

Results

Mechanical stimuli were the most commonly used modality (250 studies), followed by thermal stimuli (125 studies). Forty-six different instruments were used. Disregarding studies on widespread musculoskeletal pain and healthy participants, 40 studies evaluated TSP at painful sites, 77 in remote areas, and 66 in both locations. Of the 13 tested locations in patients, the hand (74 studies), lower leg (64 studies), and forearm (59 studies) were most commonly tested. A single practice round was the most common familiarization method (46 studies). Repeated stimuli were applied using 31
different frequencies (0.03 to 200 Hz) and sustained stimulations ranging from 5s to 1080s were used. Twenty-two different train lengths, 63 different calculations (37 absolute, 19 relative, and 7 alternatives using data directly), and 14 different outcome measures (e.g., self-reported pain rating scales and reflex thresholds) were used.

Conclusions

TSP protocols vary excessively, hindering the comparison and pooling of results. None of the studies provided substantiation for their protocol choice

References

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Presenting Author

Sjoerd Kielstra

Poster Authors

Sjoerd Kielstra

MSc

Hanze University of Applied Sciences

Lead Author

E-mail

Roland Reezigt

MSc

Hanze University of Applied Sciences

Lead Author

E-mail

Michel Coppieters

Vrije Universiteit Amsterdam

Lead Author

E-mail

Ralph de Vries

Vrije Universiteit Amsterdam

Lead Author

E-mail

Lars Arendt-Nielsen

PhD

Aalborg University

Lead Author

E-mail

David Yarnitsky

PhD

Rambam Health Care Campus

Lead Author

E-mail

Kristian Petersen

PhD

Aalborg University, Aalborg, Denmark

Lead Author

E-mail

Wendy Scholten-Peeters

Vrije universiteit Amsterdam

Lead Author

E-mail

Topics

  • Assessment and Diagnosis