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脑瘫交流型成人慢性疼痛的相关临床因素:一项横断面研究。

Clinical Factors Associated With Chronic Pain in Communicative Adults With Cerebral Palsy: A Cross-Sectional Study.

作者信息

Chin Eric M, Lenz Colleen, Ye Xiaobu, Campbell Claudia M, Stashinko Elaine, Jantzie Lauren L, Gerner Gwendolyn, Hoon Alexander H, Robinson Shenandoah

机构信息

Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

出版信息

Front Pain Res (Lausanne). 2020 Nov 24;1:553026. doi: 10.3389/fpain.2020.553026. eCollection 2020.

Abstract

Chronic pain is prevalent in adults with cerebral palsy. We aimed to explore associations between chronic pain and somatosensory, motor, cognitive, etiologic, and environmental factors in adults with cerebral palsy. This cross-sectional study enrolled 17 adult participants with cerebral palsy (mean age 31 years; 8 female; Gross Motor Functional Classification Status levels I-V) able to self-report and 10 neurotypical adult volunteers (mean age 34 years; 9 female). Participants reported pain characteristics, demographics, and affective factors. Physical examination included somatosensory and motor evaluation. Between-group comparisons used a ranksum test, and correlation analyses estimated effect size in terms of shared variance (ρ). Individuals with cerebral palsy reported greater pain intensity, neuropathic qualities, and nociceptive qualities than control participants. Higher pain intensity was associated with female gender (ρ = 16%), anxiety/depression symptoms (ρ = 10%), and lower household income (ρ = 19%). It was also associated with better communicative ability (ρ = 21%), spinothalamic (sharp/temperature) sensory abnormalities (ρ = 33%), and a greater degree of prematurity (ρ = 17%). This study highlights similarity of chronic pain associations in people with cerebral palsy with patterns seen in other populations with chronic pain. Spinothalamic sensory abnormalities suggest central pain mechanisms.

摘要

慢性疼痛在成年脑瘫患者中很常见。我们旨在探讨成年脑瘫患者慢性疼痛与体感、运动、认知、病因及环境因素之间的关联。这项横断面研究纳入了17名能够自我报告的成年脑瘫患者(平均年龄31岁;8名女性;粗大运动功能分级状态为I - V级)以及10名神经正常的成年志愿者(平均年龄34岁;9名女性)。参与者报告了疼痛特征、人口统计学信息及情感因素。体格检查包括体感和运动评估。组间比较采用秩和检验,相关分析根据共享方差(ρ)估计效应大小。与对照组参与者相比,脑瘫患者报告的疼痛强度、神经病理性特征及伤害感受性特征更高。更高的疼痛强度与女性性别(ρ = 16%)、焦虑/抑郁症状(ρ = 10%)及较低的家庭收入(ρ = 19%)相关。它还与更好的沟通能力(ρ = 21%)、脊髓丘脑束(锐痛/温度觉)感觉异常(ρ = 33%)及更高程度的早产(ρ = 17%)相关。本研究强调了脑瘫患者慢性疼痛关联与其他慢性疼痛人群中所见模式的相似性。脊髓丘脑束感觉异常提示存在中枢性疼痛机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/8915712/ee9cf0e7e427/fpain-01-553026-g0001.jpg

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