What is Quantitative Sensory Testing?
Quantitative Sensory Testing (QST) is a method used to objectively measure sensory perception, including pain, in response to various stimuli (e.g., heat, cold, pressure). Incorporating QST into your clinical trial provides reliable and standardised measurements of sensory function, allowing for more accurate assessment of pain-related conditions.
Quantitative Sensory Testing (QST) is a method used to quantify sensory perception from the skin, including pain, in response to various stimuli (e.g., heat, cold, pressure). Comprehensive and robust QST protocols have been developed (Rolke et al. 2006) which assess many sensory modalities and report these differences in a standardised format. QST can also be used selectively, identifying a modality of interest (e.g. thermal pain). The Science Behind can facilitate the resources and know-how for both comprehensive and selective testing. Incorporating QST into your clinical trial can provide reproducible and standardised measurements of sensory function, allowing for more accurate assessment of pain-related conditions.
Accessible electrophysiological measures of sensory nerve function test only large-diameter sensory fibres, however the smaller diameter fibres are crucially important in many painful and neuropathic conditions. This is where QST is unique. QST can facilitate assessments of small-diameter sensory nerve function and can be a useful primary or secondary endpoint for Phase I clinical drug trials. At The Science Behind, we utilise cutting-edge technology to deliver controlled stimulation for comprehensive QST protocols. Our services are designed to meet the rigorous demands of clinical investigations, offering unmatched precision, efficiency, and versatility.
QST can measure stimulus detection thresholds (the point at which a stimulus is felt) and pain thresholds (the point at which as stimulus becomes painful) for multiple sensory modalities. Where pain is being tested, the techniques are designed to only ever be mildly or moderately painful. Data collected on participants' sensory thresholds can be analysed statistically to determine treatment effects or disease progression.
What we offer
State of the art QST systems
Tried and tested standard protocols and procedures
Experienced and trained technicians
Data processing and quality control checks
Thermal Cutaneous Stimulation (TCS)
A thermal cutaneous stimulator is a device used to assess a person's ability to perceive temperature changes, which is a critical aspect of somatosensory function. The stimulator typically consists of a probe that can be precisely heated or cooled to specific temperatures, allowing for controlled thermal stimulation of the skin. During testing, the probe is applied to the skin, and the patient is asked to report when they feel the sensation of warmth or cold. The device can measure thresholds for detecting temperature changes and can also be used to assess thermal pain thresholds by gradually increasing or decreasing the temperature. This testing is crucial for diagnosing conditions that affect thermal perception, such as small fibre neuropathies or central nervous system disorders, and for evaluating the integrity of thermal sensory pathways in the nervous system.
Von Frey Filament Test (vF)
The Von Frey filament test, also known as the Semmes-Weinstein monofilament test, is a widely used method for assessing tactile sensitivity and detecting changes in somatosensory function. The test involves using a series of calibrated nylon filaments, each with a specific diameter and stiffness, which bend when applied with a certain force. During the test, these filaments are gently pressed against the skin, typically on areas like the feet, hands, or face, until they bend. The patient is asked to indicate when they can feel the pressure. The smallest filament that the patient can reliably detect indicates their threshold for tactile sensation. This test is particularly useful in diagnosing peripheral neuropathies, such as those caused by diabetes, and in assessing sensory nerve damage, allowing clinicians to quantify changes in sensitivity over time.
64 Hz Rydel-Seiffer tuning fork (RSTF)
The 64 Hz Rydel-Seiffer tuning fork is a specialised instrument used in clinical settings to assess vibratory sensation, which is an essential component of somatosensory function. This tuning fork is distinct from standard models due to its specific calibration to vibrate at 64 Hz and its weighted prongs, which ensure consistent vibration frequency. The fork features triangular scales marked with numbers, allowing for quantifiable measurements of vibratory sensation. During a sensory examination, the fork is struck to induce vibration and then applied to bony prominences like the big toe or fingers. Patients are asked to report when they feel the vibration and when it stops, enabling the clinician to assess the integrity of peripheral nerves. This tool is particularly valuable in diagnosing and monitoring conditions such as diabetic neuropathy.
Our team of experts are equipped to provide additional somatosensory and QST testing services beyond those mentioned. If you require further information or are interested in exploring other services, please feel free to contact us.
Advantages for Phase I clinical trials
QST allows for objective assessment of pain response, monitoring of treatment efficacy and identification of biomarkers for pain related conditions.
Benefits of including pain assessments in first in human clinical drug trials:
- Evaluate the potential side effects: Pain can be a common adverse reaction to new medications, and monitoring pain levels allows Sponsors to identify any unexpected or severe pain related adverse events early in the drug development process.
- Valuable information for dose optimisation: By monitoring pain responses at different dose levels, Sponsors can determine the most effective and tolerable dose range for the drug, maximising its therapeutic benefits while minimising adverse effects.
- Primary or Secondary Endpoint: For drugs targeting pain related conditions, such as analgesics or medications for chronic pain management, assessing pain relief is essential for demonstrating the drug’s effectiveness in proving patient outcomes.
Clinical research services
Protocol design
We understand that effective protocol design is crucial for obtaining valuable insights into drug effects, thereby de-risking and guiding future pipeline decisions. Our neuroscience research consultants, with decades of combined experience, specialise in designing and developing scientifically rigorous protocols for quantitative sensory testing (QST).Integrated solutions
We offer a comprehensive range of integrated, non-invasive solutions to stimulate and image specific brain regions, which are crucial for objectively understanding neural pathways and exploring therapeutic interventions, which can be used in combination with a wide range of QST systems for various protocols.Resourcing for data acquisition
Adhering to standard operating procedures and good clinical practice, we deploy highly trained and experienced neuroscience researchers and technicians to every clinical trial. Each team member is thoroughly trained on the specific technology solutions and the study’s data acquisition protocol. At the heart of this training is a commitment to consistently high-quality data acquisition.Data analysis and interpretation
Analysing and interpreting neuroscience data requires a deep understanding of complex neural systems and the techniques and technology used to capture this information. Our neuroscience research consultants, with backgrounds in clinical and scientific research, are highly skilled in developing and utilising specialised analysis pipelines for both single and multi-modal neuroscience data.Technical support
With over 15 years of hands-on experience in designing integrated non-invasive brain stimulation and imaging solutions for scientific research, our technical support specialists offer expertise in crafting technical solutions for each clinical trial. Once the trial begins, they are readily available to provide ongoing technical assistance, ensuring smooth operations with a focus on consistency and high-quality data acquisition.Bespoke services
Our team will collaborate with you to identify and select the appropriate tests and measures based on your drug candidate's mechanism of action, data from preclinical studies, and relevant academic and scientific literature. This approach will allow us to create a tailored solution that provides meaningful and objective endpoints while seamlessly integrating with other clinical trial measurements. If you're interested in incorporating any of these services and would like to discuss further, please get in contact!Frequently asked questions
Heat and cold stimuli are commonly used in QST to assess thermal pain perception. Participants are exposed to controlled temperatures, and their pain responses are measured. This data is essential for determining treatment effects, understanding disease progression, and evaluating the efficacy of pain-related treatments.
QST allows for objective assessment of pain response, monitoring of treatment efficacy, and identification of biomarkers for pain-related conditions. It provides precise information on sensory nerve function and pain thresholds, which are critical for evaluating the impact of new drugs and treatments in clinical trials.
We utilise cutting-edge technology to deliver controlled thermal stimulation as part of our comprehensive QST protocols. Our services are designed to meet the rigorous demands of clinical investigations, offering unmatched precision, efficiency, and versatility in pain assessments.