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New Italian normative data for the Q-Sense!

The Q-Sense device has been around since 2012 and has been serving both neurologists and pain researchers since with great success. The Q-Sense is a preferred device for small fiber testing among neurophysiologists around the globe because of its ease-of-use, dependability, and portability.

In 2019, the Q-Sense was compared in its performance to the TSA-II by the Deutscher Forschungsverbund Neuropathischer Schmerz (DFNS), the German Research Network for Neuropathic Pain. The purpose of that multi-center study by Pfau et al. was to validate the comparability of the first of a kind air-cooled Q-Sense device to the liquid-cooled TSA-II, and assess the clinical performance of this device.

The devices were then tested on both a healthy cohort and patients with diabetes. The study concluded that cold detection threshold (CDT), warm detection thresholds (WDT) and heat pain thresholds (HPT) were similar, and that the normative data collected with the TSA may be applicable to the Q-Sense as well.

Along the years, normative data has been continuously gathered with the TSA in various countries around the world, so that there is currently normative data available for adults from Taiwan (Lin, 2005), Northern India (McKnight, 2010), Australia (Hafner, 2015), Czech Republic (Buršová, 2012), Mexico (González‐Duarte, 2016) and Germany (Rolke, 2006), and pediatric normative data from The Netherlands (van den Bosch, 2017), Germany (Blankenburg, 2010), and the United States (Meier, 2001).

The latest development in the realm of QST normative data comes from Italy, where this time, normative data have been collected with Medoc’s Q-Sense CPM. In this new study by Cosentino et al. (Cosentino, 2023) from the University of Pavia, reference values have been gathered using both the methods of Limits (for CDT, WDT, HPT) and the method of Levels (for CDT, WDT). The cohort for this study consisted of 84 healthy male and female participants in the ages between 20-76 years old, divided into three age groups: 18-39, 40-59, 60-80 years old. The body sites that were included were the right thenar eminence, the dorsum of the right foot and the right supraorbital frontal area.

In congruence with Bakkers et al. (Bakkers, 2015), Cosentino et al. also found that the method of Levels showed lower WDT and higher CDT values. Differences were also found between body sites in WDT, which were higher in the foot than the face or the hand with no difference between the latter two. In CDT the lowest values were obtained in the foot, which was significantly different than both the hand and the trigeminal area, while the hand values were also significantly lower than the face in this test.

This new study is the first to collect normative data for the Italian population and for the Q-Sense device. We hope these reference values will assist clinicians and contribute to clinical use of thermal QST for small nerve fiber functionality assessment.


Bakkers, M. F. (2015). Optimizing temperature threshold testing in small‐fiber neuropathy. Muscle & Nerve, 870-876.

Blankenburg, M. B. (2010). Reference values for quantitative sensory testing in children and adolescents: developmental and gender differences of somatosensory perception. Pain, 76-88.

Buršová, Š. V. (2012). Přístrojově asistované kvantitativní testování senzitivity–normativní data. Cesk Slov Neurol, 75.

Cosentino, G. A. (2023). Age-, gender-and body site-specific reference values of thermal Quantitative Sensory Testing in the Italian population using the Q-sense device. Neurological Sciences, 1-9.

González‐Duarte, A. L.‐C.‐T. (2016). Normative values of quantitative sensory testing in Hispanic Latino population. Brain and Behavior, e00466.

Hafner, J. L. (2015). Thermal quantitative sensory testing: a study of 101 control subjects. Journal of Clinical Neuroscience, 588-591.

Lin, Y. H. (2005). Influence of aging on thermal and vibratory thresholds of quantitative sensory testing. Journal of the Peripheral Nervous System, 269-281.

McKnight, J. N.-S. (2010). Reference values for nerve function assessments among a study population in northern India-ii: Thermal sensation thresholds. Neurology Asia, 27-38.

Meier, P. M. (2001). Quantitative assessment of cutaneous thermal and vibration sensation and thermal pain detection thresholds in healthy children and adolescents. Muscle & Nerve: Official Jour. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 1339-1345.

Rolke, R. B. (2006). Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain, 231-243.

van den Bosch, G. E. (2017). Thermal quantitative sensory testing in healthy Dutch children and adolescents standardized test paradigm and Dutch reference values. BMC pediatrics, 1-10.

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