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209 Sensitivity and concurrent validity of the neuropathic pain impact on quality of life scale
Poster Presentations / Diagnosis / Assessment / European Journal of Pain 11(S1) (2007) S59–S207
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tional experimental or clinical settings, recording EPs elicited by a noxious stimulus requires subjects to stand still and hold back motor responses which are urged by the salience and nociceptive nature of the evoking stimulus. Therefore, one should consider the possibility that response inhibition contributes to the recorded brain responses. To explore brain processes underlying response-inhibition, the Go/Nogo paradigm has commonly been used within other sensory modalities. Methods. Healthy subjects performed a Go/Nogo task with a warning/imperative stimulus paradigm. Nogo-related LEPs were compared to Go-related LEPs. Two control-conditions were included: a simple reaction-time task (SRT), and a verbal stimulus-intensity rating task involving no motor preparation or execution (NM). Results. Nogo-LEPs displayed a reduced vertex P2 and enhanced frontal P3 component. The effect sizes (Cohen’s d) on the amplitudes in the Nogo- vs Go-, SRT- and NM-conditions were respectively 1.4, 0.7 and 0.8 for P2, and 0.5, 2.0 and 1.4 for P3. Conclusion. The observed response-inhibition effects appeared specific of the Nogo-task and unrelated to the waveforms observed in conventional LEP recordings.
Method. The NePIQoL was administered pre and post treatment to three groups: patients undergoing surgery for trigeminal neuralgia, patients having a spinal cord stimulator fitted for chronic neuropathic pain, and patients with neuropathic pain attending a specialist outpatient centre. In addition, all completed the SF36, Hospital Anxiety and Depression Scale and the Brief Pain Inventory. Results. Patients (N = 58) mean age 53.88 (SD 14.1) years, mean duration of pain was 10.46 (11.8) years. Internal consistency (Cronbach’s Alpha) of NePIQoL subscales pre and post treatment ranged from .66 to .87. Correlations (Pearson’s r) between NePIQoL and the other scales demonstrated logical relationships. Significant differences were found on the HADS-A, BPI total score, SF36 social functioning and NePIQoL social activity scales with the NePIQoL demonstrating the greatest effect size and SRM. Conclusions. These data suggest NePIQoL has the high internal consistency, temporal stability and responsiveness essential to reliable outcome assessment.
doi:10.1016/j.ejpain.2007.03.223
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209 SENSITIVITY AND CONCURRENT VALIDITY OF THE NEUROPATHIC PAIN IMPACT ON QUALITY OF LIFE SCALE H.M. Poole a,b, P. Murphy *,c, T.J. Nurmikko b,c a
Faculty of Science, Liverpool John Moores University, UK b Pain Research Institute, Department of Neurological Sciences, University of Liverpool, UK c The Walton Centre for Neurology and Neurosurgery NHS Trust, Liverpool, UK Background and aims. Quality of Life (QoL) measures are used to assess treatment outcomes from the patient’s perspective. Condition specific measures are advocated to counteract the reduced sensitivity of generic tools which lack disease and/or pain specificity. This paper reports on the concurrent validity and sensitivity of the Neuropathic Pain Impact on QoL measure (the NePIQoL). The content of the NePIQoL was derived from patient focus groups, its face and content validity have been demonstrated and its temporal stability established via a test–retest survey with correlations (Pearsons r) between Time 1 and Time 2 subscales all above .82.
doi:10.1016/j.ejpain.2007.03.224
MEASURING VASOMOTOR DISTURBANCES IN PATIENTS WITH A COLD INTOLERANCE AFTER NERVE INJURY S. Niehof *,a, F. Zijlstra b, F.J.P.M. Huygen a a
Department of Pain Treatment, Anaesthesiology, Rotterdam, The Netherlands b Anaesthesiology, Erasmus Mc University Medical Center, The Netherlands Background and aims. Cold intolerance can be a major disabling consequence of hand injuries. Cold exposure of body parts trigger the so-called Cold Induced Vaso Dilatation (CIVD). The purpose of this study was to develop a measurement tool to analyse the CIVD response in and between the hands of healthy persons and the hands of patients with cold intolerance after nerve injury. Methods. An aluminium plate was used through which water flows with a low temperature (5 °C ± 0.5 °C). The palmar side of both hands were cooled using this plate, to provoke a CIVD reaction. The CIVD reaction was recorded on the dorsal side of both hands using a thermographic camera (SC2000, Flir system). Results. In a healthy person, in the digiti 2 of both hands, only small differences were observed in the CIVD reaction (Fig. 1A). However in a patient with a median nerve lesion, the digiti 2 in the involved extremity did not show any CIVD reaction (Fig. 1B), whereas digiti
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tional experimental or clinical settings, recording EPs elicited by a noxious stimulus requires subjects to stand still and hold back motor responses which are urged by the salience and nociceptive nature of the evoking stimulus. Therefore, one should consider the possibility that response inhibition contributes to the recorded brain responses. To explore brain processes underlying response-inhibition, the Go/Nogo paradigm has commonly been used within other sensory modalities. Methods. Healthy subjects performed a Go/Nogo task with a warning/imperative stimulus paradigm. Nogo-related LEPs were compared to Go-related LEPs. Two control-conditions were included: a simple reaction-time task (SRT), and a verbal stimulus-intensity rating task involving no motor preparation or execution (NM). Results. Nogo-LEPs displayed a reduced vertex P2 and enhanced frontal P3 component. The effect sizes (Cohen’s d) on the amplitudes in the Nogo- vs Go-, SRT- and NM-conditions were respectively 1.4, 0.7 and 0.8 for P2, and 0.5, 2.0 and 1.4 for P3. Conclusion. The observed response-inhibition effects appeared specific of the Nogo-task and unrelated to the waveforms observed in conventional LEP recordings.
Method. The NePIQoL was administered pre and post treatment to three groups: patients undergoing surgery for trigeminal neuralgia, patients having a spinal cord stimulator fitted for chronic neuropathic pain, and patients with neuropathic pain attending a specialist outpatient centre. In addition, all completed the SF36, Hospital Anxiety and Depression Scale and the Brief Pain Inventory. Results. Patients (N = 58) mean age 53.88 (SD 14.1) years, mean duration of pain was 10.46 (11.8) years. Internal consistency (Cronbach’s Alpha) of NePIQoL subscales pre and post treatment ranged from .66 to .87. Correlations (Pearson’s r) between NePIQoL and the other scales demonstrated logical relationships. Significant differences were found on the HADS-A, BPI total score, SF36 social functioning and NePIQoL social activity scales with the NePIQoL demonstrating the greatest effect size and SRM. Conclusions. These data suggest NePIQoL has the high internal consistency, temporal stability and responsiveness essential to reliable outcome assessment.
doi:10.1016/j.ejpain.2007.03.223
210
209 SENSITIVITY AND CONCURRENT VALIDITY OF THE NEUROPATHIC PAIN IMPACT ON QUALITY OF LIFE SCALE H.M. Poole a,b, P. Murphy *,c, T.J. Nurmikko b,c a
Faculty of Science, Liverpool John Moores University, UK b Pain Research Institute, Department of Neurological Sciences, University of Liverpool, UK c The Walton Centre for Neurology and Neurosurgery NHS Trust, Liverpool, UK Background and aims. Quality of Life (QoL) measures are used to assess treatment outcomes from the patient’s perspective. Condition specific measures are advocated to counteract the reduced sensitivity of generic tools which lack disease and/or pain specificity. This paper reports on the concurrent validity and sensitivity of the Neuropathic Pain Impact on QoL measure (the NePIQoL). The content of the NePIQoL was derived from patient focus groups, its face and content validity have been demonstrated and its temporal stability established via a test–retest survey with correlations (Pearsons r) between Time 1 and Time 2 subscales all above .82.
doi:10.1016/j.ejpain.2007.03.224
MEASURING VASOMOTOR DISTURBANCES IN PATIENTS WITH A COLD INTOLERANCE AFTER NERVE INJURY S. Niehof *,a, F. Zijlstra b, F.J.P.M. Huygen a a
Department of Pain Treatment, Anaesthesiology, Rotterdam, The Netherlands b Anaesthesiology, Erasmus Mc University Medical Center, The Netherlands Background and aims. Cold intolerance can be a major disabling consequence of hand injuries. Cold exposure of body parts trigger the so-called Cold Induced Vaso Dilatation (CIVD). The purpose of this study was to develop a measurement tool to analyse the CIVD response in and between the hands of healthy persons and the hands of patients with cold intolerance after nerve injury. Methods. An aluminium plate was used through which water flows with a low temperature (5 °C ± 0.5 °C). The palmar side of both hands were cooled using this plate, to provoke a CIVD reaction. The CIVD reaction was recorded on the dorsal side of both hands using a thermographic camera (SC2000, Flir system). Results. In a healthy person, in the digiti 2 of both hands, only small differences were observed in the CIVD reaction (Fig. 1A). However in a patient with a median nerve lesion, the digiti 2 in the involved extremity did not show any CIVD reaction (Fig. 1B), whereas digiti