{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T01:06:41Z","timestamp":1775092001319,"version":"3.50.1"},"reference-count":102,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Up to 25% of people who have had carpal tunnel release surgery (CTR) fail to report improvement; however, evidence for prognostic indicators in this surgical cohort is limited. To identify candidate prognostic factors, this study investigated the association of quantitative sensory testing (QST) derived sensory phenotype and attendant impairment with patient-reported surgical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>With ethical approval and informed consent, this prospective observational longitudinal study recruited patients from two London hospitals. Multimodal phenotyping measures including quantitative sensory testing (QST), pain parameters, insomnia, pain-related worry, mood and function, were evaluated prior to; and at 3- and 6-months post-surgery. Pain in median nerve distribution with electrophysiologically confirmed conduction delay and DN4 score\u2009\u2265\u20094 was defined as neuropathic. Primary outcome was patient-rated change at 6\u2009months, dichotomised as poor outcome; \u201cworse\u201d or \u201cno change\u201d and good outcome; \u201cslightly better\u201d, \u201cmuch better\u201d or \u201ccompletely cured\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy-six patients participated. Prior to surgery, substantial heterogeneity in established categories of somatosensory function was observed with 21% of participants categorised as having a healthy sensory phenotype; 29% with thermal hyperalgesia; 32% mechanical hyperalgesia and 18% sensory loss. Seventy six percent of participants were classified as having neuropathic pain, 33% with high levels of pain related worry and 64% with clinical insomnia. Observed differences in pain, sleep impairment, psychological factors and function, between sensory phenotypic groups, was not significant. At 3- and 6-months post-surgery there was significant improvement in all phenotyping measures with a moderate to large effect size. Thermal and mechanical measures of somatosensation improved (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), as did functional ability (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Symptom severity diminished (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), as did pain-related worry (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), anxiety (<jats:italic>p<\/jats:italic>\u2009=\u20090.02) and insomnia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patient-rated surgical outcome was good in 92% of the cohort, poor in 8%. Baseline sensory phenotype category was not associated with surgical outcome however pain-related worry, anxiety and functional interference were significantly associated with outcome (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients undergoing carpal tunnel surgery, pain-related worry, anxiety and pain functional interference are candidate prognostic outcome factors and require further elucidation.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12891-021-04832-2","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T19:02:43Z","timestamp":1637175763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The association of sensory phenotype and concomitant mood, sleep and functional impairment with the outcome of carpal tunnel surgery"],"prefix":"10.1186","volume":"22","author":[{"given":"Donna L.","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Ridout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ladislava","family":"Lysakova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Vollert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline M.","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S. 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Participants provided informed, written consent for participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Participants provided informed, written consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"A.S.C. Rice: IASP Council Member and Chair 18th World Congress on Pain Scientific Programme Committee; A.S.C.R undertakes consultancy and advisory board work for Imperial College Consultants\u2014in the past 24\u2009months this has included remunerated work for Abide, Pharmanovo, Lateral, Novartis, Pharmaleads, Mundipharma, Orion, Asahi Kasei, Toray, and Theranexis; ASCR was the owner of share options in Spinifex Pharmaceuticals, from which personal benefit was accrued on the acquisition of Spinifex by Novartis in July 2015 and from which payments continued until 2019. 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