CDE Detailed Report
Disease: Headache
Subdomain Name: Imaging Diagnostics
CRF: Nociceptive Blink Reflex and Pain-Related Evoked Potentials
Displaying 1 - 25 of 25
Subdomain Name: Imaging Diagnostics
CRF: Nociceptive Blink Reflex and Pain-Related Evoked Potentials
Displaying 1 - 25 of 25
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
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| C15551 | Imaging evoked potential stimulus type | ImgEVStimulusTyp | Type of stimulus used on participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | Type of stimulus used on participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | Stimulus | Single pulse;Double pulse;Triple pulse | Single pulse;Double pulse;Triple pulse | Alphanumeric |
Triple pulse is suggested |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C55784 | Imaging evoked potential (EV) laser nociceptive stimulation model name | ImgEVLaserNcptveStmnMNam | The name of the laser nociceptive stimulation model used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the laser nociceptive stimulation model used as part of the Blink Reflex and Evoked Potential Imaging test | Model | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C15552 | Imaging stimuli duration | ImgStimuliDur | Duration of stimuli used on imaging test | Duration of stimuli used on imaging tes | Duration of stimuli | Numeric Values |
Record in 1000 microseconds |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millisecond | |||||||||
| C55785 | Imaging evoked potential (EV) Chemical nociceptive stimulation method name | ImgEVChemNcptveStmnMeNam | The name of the chemical nociceptive stimulation method used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the chemical nociceptive stimulation method used as part of the Blink Reflex and Evoked Potential Imaging test | Method | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C02411 | Laterality type | LatTyp | Laterality type relative to the anatomic site of the body examined or affected | Laterality type relative to the anatomic site of the body examined or affected | Stimulation side | Left;Right;Bilateral | Left;Right;Bilateral | Alphanumeric |
(e.g. pain side) |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C15554 | Imaging evoked potential interpulse interval 5ms value | ImgEVInterpulseIntrvl5MsVal | Interpulse interval at 5ms used on participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | Interpulse interval at 5ms used on participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | Interpulse intervals | Numeric Values |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C55786 | Imaging evoked potential (EV) Chemical nociceptive stimulation substance name | ImgEVChemNcptveStmnSubNam | The name of the chemical nociceptive stimulation substance used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the chemical nociceptive stimulation substance used as part of the Blink Reflex and Evoked Potential Imaging test | Substance | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C02494 | Imaging study date and time | ImgStdyDateTime | Date (and time, if applicable and known) the radiologic study was obtained | Date (and time, if applicable and known) the radiologic study was obtained | Date of test | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:51:00.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C15562 | Imaging total pulse count | ImgTotalPulseCt | Total number of pulses used on imaging | Total number of pulses used on imagin | Total number of averaged responses | Numeric Values |
15-20 pulses suggested |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
pulse | |||||||||
| C55787 | Imaging evoked potential (EV) recording parameter type | ImagEVRecordParaTyp | The type of recording parameter used for the imaging, as part of the Blink Reflex and Pain-Related Evoked Potentials Test | The type of recording parameter used for the imaging, as part of the Blink Reflex and Pain-Related Evoked Potentials Tes | Recording parameters | bandwidth (low-high);sweep length (in ms);sampling rate (in kHz) | bandwidth (low-high);sweep length (in ms);sampling rate (in kHz) | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 13:41:51.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Multiple Pre-Defined Values Selected |
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| C15523 | Imaging evoked potential technique type | ImgEVTechniqueTyp | Type of technique the participant/subject used as part of the Blink Reflex and Evoked Potential Imaging test | Type of technique the participant/subject used as part of the Blink Reflex and Evoked Potential Imaging test | Technique | nBR;PREP | nBR;PREP | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Multiple Pre-Defined Values Selected |
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| C15573 | Imaging stimulation target type | ImgStimlTargetTyp | The type of stimulation target of the imaging test | The type of stimulation target of the imaging tes | Stimulation target | V1;V2;V3 | V1;V2;V3 | Alphanumeric |
No additional instructions |
Rossi S, Hallett M, Rossini PM, et. Al. and The Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology 2009;120:2008-2039. Wasserman EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalography and Clinical Neurophysiology 1998;108:1-16. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C55788 | Imaging evoked potentials (EV) averaged response sequential block responses per block number | ImagEVAvgRespnsSeqBloPerBloNum | The number of sequential blocks of averaged responses and the number of responses in each block, as part of the Blink Reflex and Pain-Related Evoked Potentials Imaging test | The number of sequential blocks of averaged responses and the number of responses in each block, as part of the Blink Reflex and Pain-Related Evoked Potentials Imaging tes | Number of sequential blocks of averaged responses & number of responses in each block | Numeric Values |
Indicated whether block averaging is used, number per block and interval between blocks. |
Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 13:52:24.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C15525 | Imaging evoked potential electrical nociceptive stimulation manufacturer name | ImgEVElctrclNcptveStmnMaNam | The name of the electrical nociceptive stimulation manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the electrical nociceptive stimulation manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | Manufacturer | Alphanumeric |
Indicate equipment manufacturer and model |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C55774 | Imaging headache relation time type | ImagHeadacheRelTimeTyp | The type of timing of the imaging in relation to headache | The type of timing of the imaging in relation to headach | Stimulation timing | Inter-Ictal;Ictal;Peri-Ictal | Inter-Ictal;Ictal;Peri-Ictal | Alphanumeric |
Report the timing of the study in relation to the headache. The precise time windows of peri-ictal and inter-ictal vary with headache type. For episodic migraine, an interval of at least 72h from the last and before the next attack is generally accepted as "inter-ictal". |
Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:14:56.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C15530 | Imaging evoked potential electrical nociceptive stimulation model name | ImgEVElctrclNcptveStmnMNam | The name of the electrical nociceptive stimulation model used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the electrical nociceptive stimulation model used as part of the Blink Reflex and Evoked Potential Imaging test | Model | Alphanumeric |
Indicate equipment manufacturer and model |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C55775 | Imaging ictal pain intensity value | ImagIctPainIntensVal | The value related to the intensity of the subject's pain if the timing is ictal | The value related to the intensity of the subject's pain if the timing is ictal | If ictal, pain intensity at time of recordings | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:19:15.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
0 | 10 | ||||||||||
| C15531 | Imaging evoked potential stimulation frequency value | ImgEVStimulationFreqVal | The stimulation frequency used on the participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | The stimulation frequency used on the participant/subject as part of the Blink Reflex and Evoked Potential Imaging test | Stimulation frequency (include units) | Numeric Values |
Suggested one stimulus every 20 seconds. Include units |
Rossi S, Hallett M, Rossini PM, et. Al. and The Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology 2009;120:2008-2039. Wasserman EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalography and Clinical Neurophysiology 1998;108:1-16. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
Hertz | |||||||||
| C55776 | Imaging ictal headache since onset duration | ImagIctHeadSinceOnsetDur | The duration of time since the onset of the subject's headache if it was ictal | The duration of time since the onset of the subject's headache if it was icta | If ictal, duration of time since onset of headache (include units) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:21:21.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C15535 | Imaging evoked potential recording system manufacturer name | ImgEVRecordingSystemManufNam | The name of the recording system manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the recording system manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | Manufacturer | Alphanumeric |
Indicate equipment manufacturer and model |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C55777 | Imaging inter peri ictal headache since end duration | ImagInterPeriIctHeadSincEndDur | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe | The duration of time since the end of the subject's last inter-ictal or peri-ictal headah | If inter-ictal or peri-ictal, duration of time since end of last headache (include units) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C15542 | Imaging evoked potential recording system model name | ImgEVRecordingSystemMoNam | The name of the recording system model used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the recording system model used as part of the Blink Reflex and Evoked Potential Imaging test | Model | Alphanumeric |
Indicate equipment manufacturer and model |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
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| C55778 | Imaging inter peri ictal next headache start duration | ImagInterPeriIctNextHeStartDur | The duration of time until the start of the subject's next inter-ictal or peri-ictal headache | The duration of time until the start of the subject's next inter-ictal or peri-ictal headach | If inter-ictal or peri-ictal, duration of time until start of next headache (include units) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C15544 | Imaging stimulation intensity value | ImgStimlIntenVal | Stimulation intensity used on imaging | Stimulation intensity used on imagin | Stimulation intensity (include units) | Numeric Values |
Not more than 2.0mA; Include units |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C55783 | Imaging evoked potential (EV) laser nociceptive stimulation manufacturer name | ImgEVLaserNcptveStmnMaNam | The name of the laser nociceptive stimulation manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | The name of the laser nociceptive stimulation manufacturer used as part of the Blink Reflex and Evoked Potential Imaging test | Manufacturer | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Nociceptive Blink Reflex and Pain-Related Evoked Potentials | Imaging Diagnostics | Assessments and Examinations | 255 |
Free-Form Entry |
