1. Dual-Thermode System for Dynamic QST
Q-Sense CPM
Dual-Thermode System for Dynamic QST

2. Conditioned Pain Modulation
Descending pathways from the brain can modulate the perception of a noxious stimulus
A painful stimulus in one area of the body can inhibit a painful stimulus in another area
This effect is called Conditioned Pain Modulation (CPM). Also known as DNIC-like effect
DNIC = Diffuse Noxious Inhibitory Control

3. Q-Sense CPM Approx. 10 Kg, Portable Tabletop Unit Range: 16°C – 50°C
Rates: 0.1°C/sec - 2°C/sec
Modalities: R&H, CPM, Limits, Levels, TSL
Smart sync between Thermodes
Thermode size:
Approx. 10 Kg, Portable Tabletop Unit
30x30 mm

4. Q-Sense CPM Software Intuitive step-by-step workflow
Features are easily personalized and managed
Pre-programmed test algorithms, including dual-thermode protocols
Comprehensive statistics
Report generator
(built in + custom)
Easy data export to Excel
SQL data base

5. Movie

6. CPM pain rating graph

7. CPM pain rating with CoVAS

8. CPM pain rating with Heat Pain Threshold as a test stimulus
Medoc Ltd

9. CPM Application
Medoc Ltd

10. CPM Application – Individual Pain Profile
CPM protocol (pain inhibition) and/or Temporal Summation protocol (pain facilitation) can be used to characterize the individual pain profile and place the individual on the spectrum between pro and antinociception
The individual pain profile can be useful to predict various clinical pain characteristics, such as future pain development or treatment efficacy

11. CPM Application – Pathophysiology of Pain
CPM test can be used to assess the changes in pain inhibition and to contribute to pain profile understanding in various chronic pain conditions (Teles et al., 2018; Chalaye et al., 2014)

12. CPM Application – Post Operative Pain
CPM test can be used for identification of patients tend to develop post-operative pain – less efficient CPM is associated with higher risk to develop acute and chronic post-operative pain (Yarnitsky et al., 2008; Landau et al., 2010)

13. CPM Application – Treatment Efficacy
CPM test can used to predict the efficacy of analgesic treatment based on pain mechanism. It can also be used as an efficacy measure for different pain treatments (Yarnitsky et al., 2012; Niester et al., 2014)

14. Recently Published – 2-thermode CPM
Dual-thermode CPM: both test and conditioning stimuli are performed with 30x30 thermode
Defrin et al., (2010). The interactions between spatial summation and DNIC: Effect of the distance between two painful stimuli and attentional factors on pain perception
Nahman-Averbuch el al., (2012). The role of stimulation parameters on the conditioned pain modulation response
Razavi et al., (2013). The influence of intensity and duration of a painful conditioning stimulation on conditioned pain modulation in volunteers
Geva et al., (2014). Acute psychosocial stress reduces pain modulation capabilities in healthy men
Granovsky et al., (2015). CPM Test–Retest Reliability: “Standard” vs “Single Test-Stimulus” Protocols
Da Silva et al., (2018). Not just a matter of pain intensity: Effects of three different conditioning stimuli on conditioned pain modulation effects

15. Benefits of using 2 Thermode CPM
Computer controlled synchronization of test and conditioning stimuli
Easy to use & portable
Compared to water bath:
Suitable for all body sites
Time saving
Easy disinfection

16. Q-Sense CPM Device – Other Capabilities

17. Offset Analgesia
A profound decrease in the sensation of pain following a temporary increase in stimulus intensity
Completes the battery of dynamic QST
Source: Thesis by Marieke Niesters from the university of Leidan. Published Topic: Evoluation of endogenous analgesia.

18. Thermal Grill
Simultaneous warm and cool stimuli can cause an illusion of heat and pain => burning sensation

19. Thank you!