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Medoc's QST and PATHWAY systems assess the three types of nerve fibers generally recognized in the sensory subclass:
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A-beta fibers, the largest, which mediate the sensations of touch and mild pressure, as well as the sensation of position of joints and vibration, at a conduction velocity above 30 m/sec. |
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A-delta fibers, smaller than A-beta fibers, which mediate the sensation of cold and the first components of the sensation of pain, at a conduction velocity between 2 and 30 m/sec. |
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C fibers, the slowest and smallest, which mediate the sensation of warmth and constitute the secondary component of pain, at a conduction velocity less than 2 m/sec. |
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Small-caliber fibers (i.e., A-delta & C-fibers) constitute 70% of the peripheral nerve system. C and A-delta fibers are the only fibers responsible for pain transmission that extends from the periphery to the spinal cord and to the brain and also known as The Pain Pathway.
Traditionally, the clinical assessment of neural dysfunction consists solely of clinical examinations and nerve conduction velocity, as well as muscle electrical activity (EMG) sampling. This is limited to only the large, and fast, peripheral nerve fibers and ignores 70% of the sensory nerve fibers.
There are several diseases that affect peripheral nerves. Some affect the entire fiber spectrum, others are more selective. These include metabolic diseases such as diabetes mellitus and uremia, chronic alcohol abuse, local compression of a peripheral nerve such as carpal tunnel syndrome and nerve injuries such as CRPS or trauma.
Medoc's introduction of QST and PATHWAY systems allowed clinicians to test small nerve fibers by assessing thresholds for warmth, cold, heat-induced pain and cold-induced pain, as well as objective evoked pain response, recorded directly from the scalp. These technologically advanced systems enable both quantitative and objective measurement of sensation and pain thresholds, matched with an age-matched normal population value database. |
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