Division of Pediatric Hematology-Oncology-Bone Marrow Transplantation, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Division of Pediatric Hematology-Oncology-Bone Marrow Transplantation, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
J Pain. 2017 Oct;18(10):1216-1228. doi: 10.1016/j.jpain.2017.05.005. Epub 2017 Jun 5.
Sickle cell disease (SCD) is associated with episodes of severe vaso-occlusive pain beginning in infancy with a subset of patients with SCD transitioning to chronic pain. Response to experimental pain using quantitative sensory testing in these patients suggests altered pain processing. The objectives of this study were to characterize sensitivity to multiple modalities of experimental pain stimuli and to interrogate the relationship of psychological covariates, clinical pain burden, and pain-related outcomes to experimental pain sensitivity in children with SCD compared with healthy individuals of similar age and sex. Cross-sectional assessments of psychological characteristics were performed, and quantitative sensory testing methods were used to measure experimental pain sensitivity in children age 8 to 21 years. Anxiety, depressive symptoms, catastrophizing, and somatization were found to be associated with increased sensitivity to experimental pain stimuli. Increased frequency of painful episodes in SCD was associated with decreased sensitivity to heat pain and decreased mechanical temporal summation. These data suggest that careful consideration be given to psychological factors, age, sex, and clinical burden of pain when studying response to experimental pain in SCD.
In this study of patients with SCD, a condition associated with recurrent acute or chronic pain, psychological factors such as depression, anxiety, and catastrophizing are associated with increased sensitivity to experimental pain stimuli. Further study is need to delineate the role of these factors in chronic SCD pain.
本研究旨在描述儿童镰状细胞病(SCD)患者对多种实验性疼痛刺激的敏感性,并探讨心理变量、临床疼痛负担和与疼痛相关的结局与 SCD 患儿实验性疼痛敏感性的关系,以比较与年龄和性别相匹配的健康个体。进行了心理特征的横断面评估,并使用定量感觉测试方法测量了 8 至 21 岁儿童的实验性疼痛敏感性。结果发现焦虑、抑郁症状、灾难化和躯体化与对实验性疼痛刺激的敏感性增加有关。SCD 中疼痛发作的频率增加与热痛觉敏感性降低和机械时间总和减少有关。这些数据表明,在研究 SCD 中对实验性疼痛的反应时,应仔细考虑心理因素、年龄、性别和疼痛的临床负担。
在这项对 SCD 患者的研究中,SCD 是一种与复发性急性或慢性疼痛相关的疾病,抑郁、焦虑和灾难化等心理因素与对实验性疼痛刺激的敏感性增加有关。需要进一步研究这些因素在慢性 SCD 疼痛中的作用。