背景:小儿头痛是一个日益严重的医学问题,对儿童的生活质量产生不利影响,学业成绩,和社会功能。与健康的同龄人相比,原发性头痛的儿童表现出增强的感觉敏感性。然而,缺乏包括多模式感觉敏感性评估在内的全面调查。这项研究旨在比较原发性头痛儿童与健康同龄人在多个感觉领域的感觉敏感性。
方法:该研究包括172名6至17岁的参与者(M=13.09,SD=3.02岁;120名女孩)。这80名参与者是偏头痛患者,23名紧张型头痛患者,69人是健康对照。获得以下感官测量:机械检测阈值(MDT),机械性疼痛阈值(MPT),机械性疼痛敏感性(MPS),经皮神经电刺激(TENS)的检测和疼痛阈值,嗅觉和鼻内三叉神经检测阈值,和气味识别能力。通过一系列Kruskal-Wallis测试比较了两组之间的感觉敏感性。二项回归模型用于比较感觉敏感性测量在将参与者分为患者和健康对照时的相对效用。以及偏头痛和紧张型头痛患者。
结果:偏头痛患者前臂的MPT比紧张型头痛患者和健康对照组的MPT低。偏头痛患者的MPS高于健康对照组。所有头痛患者的TENS检测阈值较低,嗅觉敏感性较高。健康对照显示鼻内三叉神经敏感性增加。MPS中的分数,TENS,嗅觉阈值和三叉神经阈值可显著预测原发性头痛的存在。此外,MPT分数,嗅觉和三叉神经阈值是头痛类型的阳性预测因子。
结论:患有原发性头痛的儿童表现出与健康对照组不同的感觉特征。获得的结果表明存在增加的总体,原发性头痛儿童的多模态敏感性,什么可能对日常功能产生负面影响,并导致进一步的疼痛慢性化。
背景:该研究已在德国临床试验注册中心(DRKS)DRKS00021062注册。
BACKGROUND: Pediatric headache is an increasing medical problem that has adverse effects on children\'s quality of life, academic performance, and social functioning. Children with primary headaches exhibit enhanced sensory sensitivity compared to their healthy peers. However, comprehensive investigations including multimodal sensory sensitivity assessment are lacking. This study aimed to compare sensory sensitivity of children with primary headaches with their healthy peers across multiple sensory domains.
METHODS: The study included 172 participants aged 6 to 17 years (M = 13.09, SD = 3.02 years; 120 girls). Of these 80 participants were patients with migraine, 23 were patients with tension-type headache, and 69 were healthy controls. The following sensory measures were obtained: Mechanical Detection Threshold (MDT), Mechanical Pain Threshold (MPT), Mechanical Pain Sensitivity (MPS), detection and pain threshold for Transcutaneous Electrical Nerve Stimulation (TENS), olfactory and intranasal trigeminal detection threshold, and odor identification ability. Sensory sensitivity was compared between groups with a series of Kruskal-Wallis tests. Binomial regression models were used to compare the relative utility of sensory sensitivity measures in classifying participants into patients and healthy controls, as well as into patients with migraine and tension-type headache.
RESULTS: Patients with migraine had lower MPT measured at the forearm than patients with tension-type headaches and healthy controls. MPS was higher in patients with migraine than in healthy controls. All patients with headaches had lower detection threshold of TENS and higher olfactory sensitivity. Healthy controls showed increased intranasal trigeminal sensitivity. Scores in MPS, TENS, and olfactory and trigeminal thresholds were significantly predicting presence of primary headaches. Additionally, scores in MPT, olfactory and trigeminal threshold were positive predictors of type of headache.
CONCLUSIONS: Children with primary headaches exhibit different sensory profiles than healthy controls. The obtained results suggest presence of increased overall, multimodal sensitivity in children with primary headaches, what may negatively impact daily functioning and contribute to further pain chronification.
BACKGROUND: The study was registered in the German Registry of Clinical Trials (DRKS) DRKS00021062.