Temperature threshold testing: a systematic review

Mayienne Bakkers, Karin Faber, Martine J. H. Peters, Jos P. H. Reulen, Hessel Franssen, Tanya Z. Fischer, Ingemar S. J. Merkies*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The diagnosis of small fiber neuropathy (SFN) has been recently defined as typical symptoms due to small nerve fiber dysfunction accompanied by reduced intra-epidermal nerve fiber density (IENFD) or abnormal temperature threshold testing (TTT). Guidelines have been published for the assessment of IENFD. However, international guidelines for TTT are lacking. This paper presents a systematic literature review on reported TTT methods and provides recommendations for its future use in studies evaluating patients. A total of 164 papers fulfilled pre-defined requirements and were selected for review. Over 15 types of instruments are currently being used with a variety of methodological approaches for location, stimulus application, and sensation qualities examined. Consensus is needed to standardize the use of TTT as a diagnostic and follow-up tool in patients.
Original languageEnglish
Pages (from-to)7-18
JournalJournal of the Peripheral Nervous System
Issue number1
Publication statusPublished - Mar 2013


  • quantitative sensory testing
  • small fiber neuropathy
  • temperature threshold testing


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