Neurophysiology of pain in ME and FM - unpublished study by White and Bourke - CFS research Foundation/AfME

This thread has been split from a thread about a new study:
UK: Brighton and Sussex University Hospital and Medical School - Chronic Pain and Fatigue

Several years ago CFS research Foundation raised money for a pain study. After Anne Faulkner died, Afme took it over. I havent seen any paper and I've written twice to Afme about this. Got no reply. Any ideas?

 

That's the one where they gave money to Peter White, isn't it? https://www.actionforme.org.uk/reso...ology-of-pain-in-me-study-about/?c=c_db&f=178

It seems possible that some people were taking advantage of the CFS Research Foundation in the final years of Faulkner's life. It certainly seemed to change its tone on certain things.

 

That's the one.

 

So questionnaires again? And this is being touted as 'clear and validated evidence'.

 

Ah. I read QST as yet another flawed questionnaire.

So the pain was self-reported? But they were unable to see any meaningful difference on fMRI to indicate central sensitisation objectively?

 

They just quoted p values, no effect sizes or actual data, and no underlying methodology so it's hard to say what they actually measured.

 

Where was it shown that a QST shows central senzitation?

How exactly? Where's the evidence?

Isn't that normal? I remember as a child, if someone beat me repeatedly on a certain place it hurt more. I think it's quite normal.

 

Yes, a QST is subjective in the sense that you rate the pain you feel (or don't feel) via numbers of 0 to 100. But it's also objective in some parts. A QST is standardized.

First, your perception of cold and hot and your ability to distinguish warm from cold is tested. For this, a machine through which water gets pumped with a plate is put on the hand and then foot. Then the plate gets warm (up to 50°) and cold (down to 5°) very fast. This is objective in the sense that the tester knows when the plate is warm or cold, and if you say "cold" when it's actually warm it shows - if you don't cheat - that you have a problem.

Then you have to say at which point of warm or cold you feel pain. It's normal to feel too low or high temperatures as pain. This is subjective in a way. There are normal ranges.
For me, at 50° I started to feel pain, and 5° weren't painful at all.

The test goes on with little "needles" which are punched with a standardized force into the hand and foot. (For me, this was absolutely not painful.) Regarding pain, the rating is subjective. You have to distinguish during this test if a needle is pointed or flat. This, again, is objective.

In the last part of the test it's about pain rating alone. Objects like a q-tip, brush, needles are put on the hand and foot in a certain order and you have to say how painful that is for you. Here's also the "repeated punch leads to pain test". For me, this was barely/not painful and some needles I couldn't feel at all.

 

Perfect, thanks. So how does this show central sensitisation, rather than, say, peripheral neuropathy?

 

That was my question in post #10. The QST is used to diagnoze Small Fiber Neuropathy (as one part of it). I would be interested in knowing if there's evidence for a correlation between QST and central sensitisation. It's just a guess - there is no evidence.

 

I realise I replied to you, but that was a general question--and rather a rhetorical one, at that.

 

Oops.

 

No need to apologise