Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of Pediatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Geriatrics, Unit of Neurophysiopathology and Sleep Medicine, Neurosciences and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Am J Med Genet A. 2019 Jun;179(6):940-947. doi: 10.1002/ajmg.a.61111. Epub 2019 Mar 10.
Pain in individuals with RASopathies is a neglected topic in literature. In this article, we assessed prevalence and profile of pain in a sample of 80 individuals affected by RASopathies. The study sample included individuals with Noonan syndrome (N = 42), Costello syndrome (N = 17), and cardio-facio-cutaneous syndrome (N = 21). A set of standardized questionnaires and scales were administered (VAS/numeric scale, r-FLACC, Wang-Baker scale, NPSI, BPI, NCCPC-R) to detect and characterize acute and chronic pain and to study the influence of pain on quality of life (PEDs-QL, SF-36) and sleeping patterns (SDSC); revision of past medical history and multisystemic evaluation was provided. Available clinical data were correlated to the presence of pain. High prevalence of acute (44%) and chronic (61%) pain was documented in the examined sample. Due to age and intellectual disability, acute pain was localized in 18/35 individuals and chronic pain in 33/49. Muscle-skeletal and abdominal pain was more frequently reported. The intensity of acute and chronic pain interfered with daily activities in 1/3 of the sample. Pain negatively impacted on QoL and sleeping patterns. This work documents that pain is highly prevalent in RASopathies. Future studies including subjective and objective measures of pain are required to discriminate a somatosensory abnormality from an abnormal elaboration of painful stimuli at a central level.
RASopathy 患者的疼痛是文献中被忽视的话题。在本文中,我们评估了 80 名 RASopathy 患者样本中疼痛的患病率和特征。研究样本包括努南综合征(Noonan syndrome,N = 42)、科斯特罗综合征(Costello syndrome,N = 17)和心面颌骨发育不良综合征(cardio-facio-cutaneous syndrome,N = 21)患者。我们采用了一套标准化问卷和量表(VAS/数字评分法、r-FLACC、Wang-Baker 量表、NPSI、BPI、NCCPC-R)来检测和描述急性和慢性疼痛,并研究疼痛对生活质量(PEDs-QL、SF-36)和睡眠模式(SDSC)的影响;同时还进行了既往病史回顾和多系统评估。对现有临床数据与疼痛的相关性进行了分析。在检查样本中,记录到急性疼痛(44%)和慢性疼痛(61%)的高患病率。由于年龄和智力障碍,18/35 名个体出现急性疼痛,33/49 名个体出现慢性疼痛。肌肉骨骼和腹部疼痛更为常见。1/3 的样本中,急性和慢性疼痛的强度干扰了日常活动。疼痛对生活质量和睡眠模式产生负面影响。这项工作表明,疼痛在 RASopathy 中高度普遍。需要进行包括疼痛的主观和客观测量的未来研究,以区分躯体感觉异常与中枢水平病理性疼痛刺激的异常加工。