Nociception, douleur et autisme

Glaunec, Lucien Ruelle-Le; Inquimbert, Perrine; Hugel, Sylvain; Schlichter, Rémy; Bossu, Jean‐Louis

doi:10.1051/medsci/2020280

Cited by 3 publications

(3 citation statements)

References 45 publications

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“…Several studies have assessed the perception of acute pain in autistic patients [ 16 , 17 ] and suggest that their perception of pain is normal but expressed differently. In their literature review, Ruelle-Le Glaunec et al [ 18 ] describe multiple studies on populations with autism spectrum disorders, reporting either hypersensitivity, hyposensitivity, or normal sensitivity to acute pain. This demonstrates the lack of consensus regarding the issue of painful perception in patients with autism spectrum disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The DSM-V [10] also includes hypersensitivity and hyposensitivity in its definition. While many authors have focused on the question of acute pain [16][17][18], very few delve into the issue of chronic pain in patients with autism spectrum disorders. Patients with chronic pain are regularly excluded from studies on painful perception [16,17].…”

Section: Discussionmentioning

confidence: 99%

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Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report

Byl,

Morere,

Fonteyne

2024

Cureus

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The literature acknowledges the presence of psychiatric comorbidities in pediatric chronic pain populations. Few studies have focused on comorbidity with autism spectrum disorders. We describe the case of a 10-year-old patient at the onset of his care by the chronic pain team. This boy had been experiencing refractory multifocal chronic pain for three years and had undergone multiple medical examinations that had not identified the cause of the pain or provided sufficient pain relief. During our consultations, the behavioral peculiarities (averted gaze, inhibition), the atypical description of this boy's pain (pain in the hair), and sensory peculiarities (intolerance to noise) led us to suspect an autism spectrum disorder. A multidisciplinary approach, including a thorough developmental history and evaluation by an autism resource center, confirmed this suspicion. The diagnosis of an underlying autism spectrum disorder allowed us to guide our management by integrating the specific sensory aspects of this boy. Concurrently, we facilitated the family's better understanding of the young boy's issues and addressed his social and communication difficulties. Through multidisciplinary care and the integration of these various aspects, our patient's clinical situation improved. Multidisciplinary management is essential in chronic pain teams.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report

Byl,

Morere,

Fonteyne

2024

Cureus

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“…Several studies have found that people with ASD often exhibit abnormal somatic or cutaneous sensations (Asmika et al., 2018 ; Ben‐Sasson et al., 2009 ), and many observational studies have shown patients with ASD have difficulties in atypical pain perception, expression, and pain assessment (Bogdanova et al., 2022 ; Moore, 2015 ; Ruelle‐Le Glaunec et al., 2021 ; Vaughan et al., 2020 ). However, skin is the most widely distributed and earliest developing sensory organ in the human body.…”

Section: Introductionmentioning

confidence: 99%

Disturbance of skin sensation and autism spectrum disorder: A bidirectional Mendelian randomization study

Zhong,

Wang,

et al. 2023

Brain and Behavior

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Background and aimPatients with autism spectrum disorder (ASD) commonly experience aberrant skin sensation sensitivity; however, the causal relationship is not yet clear. This study uses a bidirectional Mendelian randomization (MR) method to explore the relationship between disturbance of skin sensation (DSS) and ASD.MethodsSingle‐nucleotide polymorphisms (SNPs) extracted from the summary data of genome‐wide association studies were used as genetic instruments. MR was performed using the inverse‐variance‐weighted method, with alternate methods (e.g., weighted median, MR‐Egger, simple mode, weighted mode, and MR‐pleiotropy residual sum and outlier) and multiple sensitivity analyses to assess horizontal pleiotropy and remove outliers.ResultsThe results of the analysis using six SNPs as genetic instruments showed that the DSS is associated with an increased risk of ASD (odds ratio = 1.126, 95% confidence interval = 1.029–1.132; p = .010). The results of the sensitivity analyses were robust with no evidence of pleiotropy. The reverse MR analyses showed no causal effects of ASD on DSS.ConclusionThis study's findings suggest that DSS has potential causal effects on ASD, whereas ASD has no effect on DSS. Thus, skin sensitivity may represent a behavioral marker of ASD, by which some populations could be subtyped in the future.

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The Current View on the Paradox of Pain in Autism Spectrum Disorders

et al. 2022

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which affects 1 in 44 children and may cause severe disabilities. Besides socio-communicational difficulties and repetitive behaviors, ASD also presents as atypical sensorimotor function and pain reactivity. While chronic pain is a frequent co-morbidity in autism, pain management in this population is often insufficient because of difficulties in pain evaluation, worsening their prognosis and perhaps driving higher mortality rates. Previous observations have tended to oversimplify the experience of pain in autism as being insensitive to painful stimuli. Various findings in the past 15 years have challenged and complicated this dogma. However, a relatively small number of studies investigates the physiological correlates of pain reactivity in ASD. We explore the possibility that atypical pain perception in people with ASD is mediated by alterations in pain perception, transmission, expression and modulation, and through interactions between these processes. These complex interactions may account for the great variability and sometimes contradictory findings from the studies. A growing body of evidence is challenging the idea of alterations in pain processing in ASD due to a single factor, and calls for an integrative view. We propose a model of the pain cycle that includes the interplay between the molecular and neurophysiological pathways of pain processing and it conscious appraisal that may interfere with pain reactivity and coping in autism. The role of social factors in pain-induced response is also discussed. Pain assessment in clinical care is mostly based on subjective rather than objective measures. This review clarifies the strong need for a consistent methodology, and describes innovative tools to cope with the heterogeneity of pain expression in ASD, enabling individualized assessment. Multiple measures, including self-reporting, informant reporting, clinician-assessed, and purely physiological metrics may provide more consistent results. An integrative view on the regulation of the pain cycle offers a more robust framework to characterize the experience of pain in autism.

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Nociception, douleur et autisme

Cited by 3 publications

References 45 publications

Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report

Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report

Disturbance of skin sensation and autism spectrum disorder: A bidirectional Mendelian randomization study

The Current View on the Paradox of Pain in Autism Spectrum Disorders

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