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J Pain. 2013 Jan;14(1):79-88. doi: 10.1016/j.jpain.2012.10.010.

Test-retest reliability of thermal temporal summation using an individualized protocol.

Author information

1
Department of Anesthesia, Division of Pain Medicine, Stanford Neuroscience and Pain Laboratory, Stanford University, Palo Alto, California 94304, USA.

Abstract

Temporal summation (TS) refers to the increased perception of pain with repetitive noxious stimuli. It is a behavioral correlate of wind-up, the spinal facilitation of recurring C-fiber stimulation. In order to utilize TS in clinical pain research, it is important to characterize TS in a wide range of individuals and to establish its test-retest reliability. Building on a fixed-parameter protocol, we developed an individually adjusted protocol to broadly capture thermally generated TS. We then examined the test-retest reliability of TS within-day (intertrial intervals ranging from 2 to 30 minutes) and between-days (intersession interval of 7 days). We generated TS-like effects in 19 of the 21 participants. Strong correlations were observed across all trials over both days (intraclass correlation [ICC] [A, 10] = .97, 95% confidence level [CL] = .94-.99) and across the initial trials between days (ICC [A, 1] = .83, 95% CL = .58-.93). Repeated measures mixed-effects modeling demonstrated no significant within-day variation and only a small (5 out of 100 points) between-day variation. Finally, a Bland-Altman analysis suggested that TS is reliable across the range of observed scores. Without intervention, thermally-generated TS is generally stable within day and between days.

PERSPECTIVE:

Our study introduces a new strategy to generate thermal TS in a high proportion of individuals. This study confirms the test-retest reliability of thermal TS, supporting its use as a consistent behavioral correlate of central nociceptive facilitation.

PMID:
23273835
PMCID:
PMC3541942
DOI:
10.1016/j.jpain.2012.10.010
[Indexed for MEDLINE]
Free PMC Article

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