目的:我们调查了在患有和不患有慢性疼痛的脑瘫(CCP)的儿童和青少年中通过定量感觉测试评估的体感特征(SSP)的差异,并将这些差异与患有和不患有慢性疼痛的典型儿童和青少年(TDC)中的差异进行了比较。
方法:所有纳入的受试者均由同一研究者连续招募并在同一门诊骨科诊所进行测试。测试了受试者的反应时间。SSP包括以下测试:温暖(WDT),cool(CDT),机械(MDT),和振动(VDT)检测阈值;热(HPT),压力(PPT),和机械(MPT)疼痛阈值;发条比(WUR);使用条件疼痛调节(CPM)范式的动态机械异常性疼痛(DMA)和冷加压试验(CPT)。
结果:我们包括25个CCP和26个TDC。无慢性疼痛的TDC作为对照。在慢性疼痛的TDC中,WDT,HPT,HPT强度,和PPT高于对照组。没有观察到有和没有慢性疼痛的CCP之间的SSP差异。在CCP,MDT,WDT,CDT,HPT强度高于对照组。CCP的反应时间比TDC长。其余变量没有差异。
结论:在CCP中,SSP与疼痛状态和MR图像的发现无关.在所有CCP中,SSP与慢性疼痛的TDC相似,与没有慢性疼痛的TDC相比。这表明CCP没有激活和引起中枢和周围神经系统功能变化的正常神经可塑性适应过程。
OBJECTIVE: We investigated differences in somatosensory profiles (SSPs) assessed by quantitative sensory testing in children and adolescents with cerebral palsy (CCP) with and without chronic pain and compared these differences to those in a group of typically developed children and adolescents (TDC) with and without chronic pain.
METHODS: All included subjects were consecutively recruited from and tested at the same outpatient orthopedic clinic by the same investigator. The subjects had their reaction times tested. The SSP consisted of the following tests: warmth (WDT), cool (CDT), mechanical (MDT), and vibration (VDT) detection thresholds; heat (HPT), pressure (PPT), and mechanical (MPT) pain thresholds; wind-up ratio (WUR); dynamic mechanical allodynia (DMA) and cold pressor test (CPT) using a conditioned pain modulation (CPM) paradigm.
RESULTS: We included 25 CCP and 26 TDC. TDC without chronic pain served as controls. In TDC with chronic pain, WDT, HPT, HPT intensity, and PPT were higher than in controls. No differences in SSPs between CCP with and without chronic pain were observed. In CCP, the MDT, WDT, CDT, and HPT intensity were higher than in controls. CCP had longer reaction times than TDC. There were no differences regarding the remaining variables.
CONCLUSIONS: In CCP, the SSPs were independent of pain status and findings on MR images. In all CCP the SSPs resembled TDC with chronic pain, compared to TDC without chronic pain. This suggests that CCP do not have the normal neuroplastic adaptive processes that activate and elicit functional changes in the central and peripheral nervous systems.