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LETTERS TO THE EDITOR

Current Perception Thresholds Do Not Vary Significantly

Neurotron, Inc., Evergreen Medical Consultants, Evergreen, CO

To the Editor:

The article by Shimoda and Ikuta (1) was informative and well written. The coefficients of variation (CV) for repeated measures were not considered in the statistical analysis, and consequently their conclusions are erroneous. The reported CV for CPT measures varies from 4.7% to 27.5% depending on the CPT stimulus frequency (2–5). The difference of the mean CPT measures at each frequency between the horizontal and 70° tilt-up position fell within the previously published CV. Although these changes in CPTs might have been statistically significant, they might not be clinically relevant. Clinical significance is based on the determination of whether the analysis of the measure reveals if it is normal or abnormal and how severe. All the CPT measures in this study remained well within the established normative variables. Interestingly, the authors point out that there is a relationship between hypertension and pain perception. Assessment of pain tolerance thresholds using the same device as used in this study (Neurometer^® CPT/C; Neurotron, Inc., Baltimore, MD) is possible (6). Perhaps assessment of pain tolerance thresholds would have yielded more significant results.

Dr. Shimoda does not wish to respond.

References

1. Shimoda O, Ikuta Y. The current perception thresholds vary between horizontal and 70 degree tilt-up positions. Anesth Analg 2000; 91: 398–402.[Abstract/Free Full Text]
2. Masson EA, Veves A, Fernando D, et al. Current perception thresholds: a new, quick, and reproducible method for the assessment of peripheral neuropathy in diabetes mellitus. Diabetalogia 1989; 32: 724–8.[Web of Science][Medline]
3. Katims JJ, Rouvelas P, Sadler B, et al. Current perception threshold: repeatability and comparison with nerve conduction in evaluation of carpal tunnel syndrome. Trans Am Soc Artif Intern Org 1989; 35: 280–4.
4. Barkai L, Kempler P, Vámosi I, et al. Peripheral sensory nerve dysfunction in children and adolescents with Type 1 diabetes mellitus. Diabetic Med 1998; 15: 228–33.[Medline]
5. Takekuma K, Ando F, Niino N, Shimokata H. Age and gender differences in skin sensory threshold assessed by current perception in community-dwelling Japanese. J Epidemiology 2000; 10: S33–8.
6. Katims JJ. Electrodiagnostic functional sensory evaluation of the patient with pain: a review of the neuroselective current perception threshold (CPT) and pain tolerance threshold (PTT). Pain Digest 1998; 8: 219–30.

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