Division of Pediatric Anesthesiology, Department of Anesthesiology, Duke University, Durham, NC 27710, United States.
Duke University School of Nursing, Durham, NC 27710, United States.
Pain Med. 2024 Feb 1;25(2):144-156. doi: 10.1093/pm/pnad133.
Over 50% of adults living with sickle cell disease (SCD) have chronic pain, but the underlying mechanisms of chronic pain in this population remain unclear. Quantitative sensory testing is an important measurement tool for understanding pain and sensory processing. This scoping review summarizes quantitative sensory testing methodologies used in sickle cell studies and the evidence for central sensitization in this population.
We conducted a systematic search of PubMed, Embase, and CINAHL to identify studies using quantitative sensory testing in individuals living with sickle cell disease. Search strategies were based on variations of the terms "sickle cell disease," and "quantitative sensory testing." Eligible studies were observational or experimental studies in human participants living with SCD that reported findings and detailed methodology for at least 1 quantitative sensory testing modality.
Our search yielded a total of 274 records; 27 of which are included in this scoping review. Of the 27 studies, 17 were original studies (with combined total of 516 adult and 298 pediatric participants), and 10 were secondary or subgroup analyses of these prior studies. Significant variation existed in quantitative sensory testing methodologies across studies, including testing locations, type and intensity of stimuli, and interpretation of findings. Of the identified studies, 22% (2/9 studies) reported sensory abnormalities in mechanical sensitivity and thresholds, 22% (2/9 studies) reported abnormal pressure pain thresholds, 46% (6/13 studies) reported sensory abnormalities in thermal pain thresholds and tolerance (cold and warm), and 50% (2/4 studies) reported abnormalities in temporal summation.
Future studies should use standardized quantitative sensory testing protocols with consistent and operationalized definitions of sensitization to provide clear insight about pain processing and central sensitization in sickle cell disease.
超过 50%的镰状细胞病（SCD）成年患者存在慢性疼痛，但该人群慢性疼痛的潜在机制仍不清楚。定量感觉测试是理解疼痛和感觉处理的重要测量工具。本范围综述总结了用于 SCD 研究的定量感觉测试方法学以及该人群中中枢敏化的证据。
我们对 PubMed、Embase 和 CINAHL 进行了系统检索，以确定使用定量感觉测试在 SCD 患者中进行的研究。搜索策略基于“镰状细胞病”和“定量感觉测试”术语的变体。符合条件的研究是在 SCD 患者中进行的观察性或实验性研究，这些研究报告了至少 1 种定量感觉测试模式的发现和详细方法学。
我们的搜索共产生了 274 条记录；其中 27 条被纳入本范围综述。在这 27 项研究中，有 17 项是原始研究（共有 516 名成年和 298 名儿科参与者），10 项是这些先前研究的二次或亚组分析。研究之间的定量感觉测试方法学存在显著差异，包括测试位置、刺激类型和强度以及结果解释。在所确定的研究中，22%（2/9 项研究）报告了机械敏感性和阈值的感觉异常，22%（2/9 项研究）报告了异常的压力疼痛阈值，46%（6/13 项研究）报告了热痛阈值和耐受（冷和热）的感觉异常，50%（2/4 项研究）报告了时间总和的异常。
未来的研究应使用标准化的定量感觉测试方案，并对敏化作用具有一致和可操作的定义，以提供关于 SCD 中疼痛处理和中枢敏化的清晰见解。
