38 Interpretation of normative values is difficult due to great differences in methods between normative value studies The comparison between the painful and contralateral site is difficult due to the absence of the minimum meaningful difference150 Microneurography Invasive Technically demanding Labor intensive Measurement of a single small nerve fiber151 No normative values available Only used in studies152 Level 4 Parasympathetic tests and sympathetic adrenergic tests Cardiovagal tests Response is dependent on duration, strain level, rate of pressure change, body position in which it will be performed (not standardized), fluid status, duration and position of rest before the maneuver, rat of inspiration, time of the day, room temperature, food intake, caffeine, nicotine, medication, , manner of starting (voluntary or after signal), and age.107 Complex underlying physiologic mechanisms106 Lack of widespread standardization in methods and normative values Many different devices available, including custom-made Need for training and expertise105 Level 1 Pupillometry Magnitude of reflex is variable and affected by the initial pupil size Without solid standardization of testing conditions, the test lacks sensitivity109 Difficult to interpret the results, disorders do present symmetric in the eyes.114 Level 1 Bladder function tests Good calibration is required Good cooperation with and instruction of the patients is necessary Quality check of the results is important, may be influenced by artefacts125 Level 1 Sympathetic cholinergic tests Thermoregulatory Sweat Test (TST) Not applicable for routine use, except in highly specialized centers Time-consuming Special equipment is required Requires a lot of space Requires special preparation of the patient76 Level 3 Quantitative Sudomotor AxonReflex Test (QSART) Special equipment is required Staff needs to be trained Expensive76 Level 2 40 2
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