Objective: Stimulated skin wrinkling test (SSW) has been launched as a non-invasive diagnostic procedure. However, no normative age dependent values have been reported that can be applied in clinical practice. The objectives of the study were to (1) collect age-dependent normative values according to the 5-point scale assessment for the SSW, to (2) determine reliability scores for the obtained norm values, and to (3) introduce a new digital method for SSW assessment, the Digit Wrinkle Scan© (DWS©) for detection of wrinkles in a more quantitative manner. Methods: Firstly, 82 healthy participants were included, divided in 5 age groups. The participants underwent SSW using lidocaine and prilocaine topical cream. Secondly, 35 healthy participants were included to test whether the DWS© could be a novel manner to assess the grade of wrinkling quantitatively. We determined the inter-observer reliability of both methods Also, the intra-observer reliability was calculated for the DWS©. Results: We found a decrease in normative values over age. The inter-observer reliability of assessment by the 5-point scale method was moderate after SSW (Cohen’s k: 0.53). Results of the DWS© indicate that total wrinkle length per mm2 showed moderate to good agreement for the 4th and 5th digits after SSW, and a low agreement for the other digits. Conclusion: Age-dependent normative values were obtained according to the 5-point scale, but its clinical application is doubtful since we found a moderate inter-observer reliability. We introduced the DWS© as a possible new method in order to quantify the grade of wrinkling. Significance: We found unsatisfactory reliability scores, which hampers its usefulness for clinical practice.
Maurice Sopacua studied Human Movement Sciences at the VU University in Amsterdam, the Netherlands. He graduated for his Master's degree in the field of Rehabilitation & Physiotherapy. After that, he studied Medicine at the Rijks universiteit Groningen, the Netherlands. He started his PhD-research in the Neurology department of Maastricht UMC+, under supervision of Prof. C.G. Faber, with the title 'Improving the assessments of the diagnosis of Small Fiber Neuropathy'. In the thesis, he focused on genetic epidemiological research and clinical diagnostic tools. From June 2018, he started as resident in Rehabilitation Medicine in Adelante Zorggroep, Hoensbroek, the Netherlands. Since March 2022, he is a PM&R specialist in Libra Revalidatie & Audiologie, Eindhoven, the Netherlands. His daily practice is in the hospitals Sint Jans Gasthuis (Weert, The Netherlands) and Elkerliek Ziekenhuis (Helmond, the Netherlands). His specialization is in the field of chronic pain, neurodegenerative and neuromuscular disorders
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