de Knegt Nanda, Defrin Ruth, Schuengel Carlo, Lobbezoo Frank, Evenhuis Heleen, Scherder Erik
Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel.
Res Dev Disabil. 2015 Dec;47:306-17. doi: 10.1016/j.ridd.2015.08.016. Epub 2015 Oct 23.
The spinothalamic pathway mediates sensations of temperature, pain, and touch. These functions seem impaired in children with Down syndrome (DS), but have not been extensively examined in adults. The objective of the present study was to compare the spinothalamic-mediated sensory functions between adults with DS and adults from the general population and to examine in the DS group the relationship between the sensory functions and level of intellectual functioning. Quantitative sensory testing (QST) was performed in 188 adults with DS (mean age 37.5 years) and 142 age-matched control participants (median age 40.5 years). Temperature, pain, and touch were evaluated with tests for cold-warm discrimination, sharp-dull discrimination (pinprick), and tactile threshold, respectively. Level of intellectual functioning was estimated with the Social Functioning Scale for Intellectual Disability (intellectual disability level) and the Wechsler Preschool and Primary Scale of Intelligence--Revised (intelligence level). Overall, the difference in spinothalamic-mediated sensory functions between the DS and control groups was not statistically significant. However, DS participants with a lower intelligence level had a statistically significant lower performance on the sharp-dull discrimination test than DS participants with higher intelligence level (adjusted p=.006) and control participants (adjusted p=.017). It was concluded that intellectual functioning level is an important factor to take into account for the assessment of spinothalamic-mediated sensory functioning in adults with DS: a lower level could coincide with impaired sensory functioning, but could also hamper QST assessment.
脊髓丘脑束传导通路介导温度、疼痛和触觉的感觉。这些功能在唐氏综合征（DS）患儿中似乎受损，但在成人中尚未得到广泛研究。本研究的目的是比较DS成人与普通人群成人之间脊髓丘脑束介导的感觉功能，并在DS组中研究感觉功能与智力功能水平之间的关系。对188名DS成人（平均年龄37.5岁）和142名年龄匹配的对照参与者（年龄中位数40.5岁）进行了定量感觉测试（QST）。分别通过冷-热辨别测试、锐-钝辨别测试（针刺）和触觉阈值测试来评估温度、疼痛和触觉。使用智力残疾社会功能量表（智力残疾水平）和韦氏学前及初小儿童智力测验修订版（智力水平）来评估智力功能水平。总体而言，DS组和对照组之间脊髓丘脑束介导的感觉功能差异无统计学意义。然而，智力水平较低的DS参与者在锐-钝辨别测试中的表现显著低于智力水平较高的DS参与者（校正p = 0.006）和对照参与者（校正p = 0.017）。研究得出结论，在评估DS成人脊髓丘脑束介导的感觉功能时，智力功能水平是一个需要考虑的重要因素：较低的智力水平可能与感觉功能受损同时出现，但也可能妨碍QST评估。
