Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
Sci Rep. 2023 Sep 20;13(1):15564. doi: 10.1038/s41598-023-42982-6.
This study aimed to investigate the association between facial action units and pain levels in Syrian children, focusing on both genuine and fake pain expressions. A total of 300 Syrian children aged 6-9 years participated in the study. Pain levels were assessed using the validated Face, Legs, Activity, Cry, Consolability scale, and facial expressions were analyzed using the Facial Action Coding System. The children were asked to mimic their feelings after receiving a dental injection to elicit fake pain expressions. Statistical analysis, including multinomial logistic regression and chi-square tests, was conducted to determine the Action Units (AUs) associated with each pain level and to compare the differences between real and fake pain expressions. The results revealed significant associations between specific AUs and pain levels. For real pain expressions, the most activated AUs across different pain levels with positive coefficient values of correlation (P-value < 0.01) were analyzed. In contrast, for fake pain expressions, AU12 and AU38 were consistently observed to be the most activated. These findings suggest that certain AUs are uniquely associated with fake pain expressions, distinct from those observed in real pain expressions. Furthermore, there were no significant differences between boys and girls in terms of their genuine and fake pain expressions, indicating a similar pattern of AU activation (P-value > 0.05). It was concluded that AUs 4, 6, 41, and 46 were associated with mild pain, and AUs 4, 6, 41, 46, and 11 were associated with moderate pain cases. In severe pain, AUs 4, 6, 7, 9, 11, and 43 were associated. In fake pain feelings, AU43, AU38, and AU12 were the most activated with no difference between boys and girls.
本研究旨在探讨叙利亚儿童面部动作单元与疼痛程度之间的关系，重点关注真实和虚假疼痛表情。共有 300 名 6-9 岁的叙利亚儿童参与了这项研究。使用经过验证的面部、腿部、活动、哭泣、安抚量表评估疼痛程度，并使用面部动作编码系统分析面部表情。要求孩子们在接受牙科注射后模仿自己的感觉，以引出虚假的疼痛表情。进行了统计分析，包括多项逻辑回归和卡方检验，以确定与每个疼痛程度相关的动作单元（AU），并比较真实和虚假疼痛表情之间的差异。结果表明，特定的 AU 与疼痛程度之间存在显著关联。对于真实的疼痛表情，分析了不同疼痛程度下具有正相关系数值（P 值<0.01）的最活跃 AU。相比之下，对于虚假的疼痛表情，AU12 和 AU38 被一致观察到是最活跃的。这些发现表明，某些 AU 与虚假疼痛表情独特相关，与真实疼痛表情中观察到的不同。此外，男孩和女孩在真实和虚假疼痛表情方面没有显著差异，表明 AU 激活模式相似（P 值>0.05）。研究得出结论，AU4、6、41 和 46 与轻度疼痛相关，AU4、6、41、46 和 11 与中度疼痛相关。在严重疼痛中，AU4、6、7、9、11 和 43 与疼痛相关。在虚假疼痛感觉中，AU43、AU38 和 AU12 是最活跃的，男孩和女孩之间没有差异。
