Peterson Mark D, Haapala Heidi J, Kratz Anna
Department of Physical Medicine and Rehabilitation (MDP, HJH, AK), Michigan Medicine, University of Michigan, Ann Arbor; and Institute for Healthcare Policy and Innovation (MDP), Michigan Medicine, University of Michigan, Ann Arbor.
Neurol Clin Pract. 2021 Dec;11(6):e848-e855. doi: 10.1212/CPJ.0000000000001113.
To identify pain phenotypes among adults living with cerebral palsy (CP) and compare phenotypes of pain intensity, anxiety and depressive symptoms, and self-reported perceived stress.
Seventy-one adults with CP presented to the University of Michigan (mean age = 39.3 ± 16.2; 43 women, 28 men). The median of 6 on the American College of Rheumatology fibromyalgia survey was used to classify patients for nociplastic pain centralization. The painDETECT Score was used to classify patients for neuropathic pain. These measures were then used to cross-classify each patient into 1 of 4 possible pain categories: neuropathic, nociplastic, mixed neuropathic/noclipastic, or nociceptive pain (-neuropathic/-nociplastic pain).
Twenty-eight adults with CP (39.4%) were classified as nociceptive, 24 (33.8%) as nociplastic, 8 (11.3%) as neuropathic, and 11 (15.5%) as mixed neuropathic/nociplastic. Subgroups differed significantly on average scores on the Brief Pain Inventory pain intensity scale, the Perceived Stress Scale, and on the Patient-Reported Outcomes Measurement Information System measures of anxiety and depression; the nociceptive pain subgroup reported lower pain and emotional distress compared with the other groups.
Findings suggest that type of pain is variable among adults with CP and may arise through multiple mechanisms.
确定成年脑瘫患者的疼痛表型，并比较疼痛强度、焦虑和抑郁症状以及自我报告的感知压力的表型。
71名成年脑瘫患者前往密歇根大学就诊（平均年龄=39.3±16.2岁；43名女性，28名男性）。美国风湿病学会纤维肌痛调查中6分的中位数用于对伤害感受性疼痛集中化的患者进行分类。疼痛检测评分用于对神经性疼痛的患者进行分类。然后使用这些测量方法将每位患者交叉分类为4种可能的疼痛类别之一：神经性、伤害感受性、混合性神经性/伤害感受性或伤害性疼痛（非神经性/非伤害感受性疼痛）。
28名成年脑瘫患者（39.4%）被分类为伤害性疼痛，24名（33.8%）为伤害感受性疼痛，8名（11.3%）为神经性疼痛，11名（15.5%）为混合性神经性/伤害感受性疼痛。各亚组在简明疼痛量表疼痛强度量表、感知压力量表以及患者报告结果测量信息系统的焦虑和抑郁测量指标的平均得分上存在显著差异；与其他组相比，伤害性疼痛亚组报告的疼痛和情绪困扰较低。
研究结果表明，成年脑瘫患者的疼痛类型各不相同，可能通过多种机制产生。
