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Quantitative sensory testing profiles in children, adolescents and young adults (6–20 years) with cerebral palsy : Hints for a neuropathic genesis of pain syndromes

  • Introduction: Many patients with cerebral palsy (CP) suffer chronic pain as one of the most limiting factors in their quality of life. In CP patients, pain mechanisms are not well understood, and pain therapy remains a challenge. Quantitative sensory testing (QST) might provide unique information about the functional status of the somatosensory system and therefore better guide pain treatment. Objectives: To understand better the underlying pain mechanisms in pediatric CP patients, we aimed to assess clinical and pain parameters, as well as QST profiles, which were matched to the patients' cerebral imaging pathology. Patients and methods: Thirty CP patients aged 6–20 years old (mean age 12 years) without intellectual impairment underwent standardized assessments of QST. Cerebral imaging was reassessed. QST results were compared to age- and sex-matched controls (multiple linear regression; Fisher's exact test; linear correlation analysis). Results: CP patients were less sensitive to all mechanical and thermal stimuli than healthy controls but more sensitive to all mechanical pain stimuli (each p < 0.001). Fifty percent of CP patients showed a combination of mechanical hypoesthesia, thermal hypoesthesia and mechanical hyperalgesia; 67% of CP patients had periventricular leukomalacia (PVL), which was correlated with mechanic (r = 0.661; p < 0.001) and thermal (r = 0.624; p = 0.001) hypoesthesia. Conclusion: The combination of mechanical hypoesthesia, thermal hypoesthesia and mechanical hyperalgesia in our CP patients implicates lemniscal and extralemniscal neuron dysfunction in the thalamus region, likely due to PVL. We suspect that extralemniscal tracts are involved in the original of pain in our CP patients, as in adults.

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Metadaten
Author:Markus R. BlankenburgORCiD, J. Junker, Gerrit HirschfeldORCiD, Erik Michel, Furkan Aksu, Julia WagerORCiD, Boris ZernikowORCiD
Title (English):Quantitative sensory testing profiles in children, adolescents and young adults (6–20 years) with cerebral palsy : Hints for a neuropathic genesis of pain syndromes
DOI:https://doi.org/10.1016/j.ejpn.2017.12.015
ISSN:1532-2130
Parent Title (English):European Journal of Paediatric Neurology
Document Type:Article
Language:English
Year of Completion:2018
electronic ID:Zur Anzeige in scinos
Release Date:2021/08/03
Tag:Cerebral palsy; Children; Neuropathic pain; Quantitative sensory testing
Volume:22
Issue:3
First Page:470
Last Page:481
Note:
Zugriff im Hochschulnetz
Faculties:Fakultät WiSo
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion