Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study

Parkinson, Kathryn; Dickinson, Heather O; Arnaud, Catherine; Lyons, Alan; Colver, Allan

doi:10.1136/archdischild-2012-303482

Cited by 145 publications

(241 citation statements)

References 32 publications

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“…Previous multicenter studies have shown the prevalence of pain in the CP population to be 75-80% 26,27 which is similar to the prevalence of 87% in CP patients with spasticity found in the current study. Likewise, our data in patients with spasticity concurs with previous studies that reported prevalence of pain in stroke to be 19-75%, [26][27][28] 53% in MS, 29 64.9% in SCI 30 and 70% in brain injured patients.…”

Section: Discussionsupporting

confidence: 90%

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Shaikh

Phadke

Ismail

et al. 2015

Can. J. Neurol. Sci.

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Objective: To assess the prevalence of pain in adults with spasticity and to assess the association between the subjective experience of pain and spasticity. Design: Cross-sectional study. Setting: outpatient spasticity management clinic of a rehabilitation centre. Patients: Patients with upper motor neuron lesions and spasticity (n = 131) were recruited. Methods: We assessed pain intensity and location, relationship between spasticity and pain perception, and perception of pain relief from botulinum toxin type-A (BoNTA) injections. Main outcome measures: Pain perception rated on a 10-point numerical rating scale and pain quality. Results: 65% of the patients with spasticity reported presence of pain and 60% described it as an aching pain. More patients reported pain with movement (34%) compared to rest (21%). There was a statistically poor correlation between the severity of pain and spasticity (r = 0.16; p > 0.05). Most patients (80%) believed that their pain was related to spasticity and 62% reported that BoNTA injections decreased their pain. Conclusions: The high incidence of pain noted within our sample suggests that physicians may have to consider pain management as part of spasticity treatment. Participants reported that their pain was related to their spasticity, and that it decreased after BoNTA treatment. Further study is needed to explore the relationships between objective measures of spasticity and pain.RÉSUMÉ: Relation entre la toxine botulique, la spasticité et la douleur : une enquête sur la perception des patients. Objectif: Le but de l'étude était de déterminer la prévalence de la douleur chez des adultes souffrant de spasticité et d'étudier l'association entre l'expérience subjective de la douleur et la spasticité. Devis de l'étude: Il s'agit d'une étude transversale. Contexte: Cette étude a été réalisée auprès de patients fréquentant une clinique dédiée au traitement de la spasticité dans un centre de réadaptation. Patients: Des patients atteints de lésions du neurone moteur supérieur et de spasticité ont été recrutés (n = 131). Méthode: Nous avons évalué l'intensité et la localisation de la douleur, la relation entre la spasticité et la perception de la douleur ainsi que la perception du soulagement de la douleur suite à des injections de toxine botulique de type A (BoNTA). Principaux critères d'évaluation: Les critères utilisés étaient la perception de la douleur évaluée sur une échelle numérique de 10 points et la qualité de la douleur. Résultats: Soixante-cinq pour cent des patients présentant de la spasticité ont rapporté la présence de douleur et 60% l'ont décrite comme une douleur sourde. Plus de patients ont rapporté de la douleur au mouvement (34%) qu'au repos (21%). La corrélation entre la sévérité de la douleur et la spasticité était faible au point de vue statistique (r = 0,16 ; p > 0,05). La plupart des patients (80%) croyaient que leur douleur était reliée à la spasticité et 62% rapportaient que les injections de BoNTA diminuaient la douleur. Conclusions: L'incidence ...

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Section: Discussionsupporting

confidence: 90%

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Shaikh

Phadke

Ismail

et al. 2015

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

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“…Although this level was high, it was still lower than the 50‐75% reported by other CP studies 4, 6, 8, 9, 15. A number of explanations can account for this apparent discrepancy.…”

Section: Discussionmentioning

confidence: 57%

“…Some of the other studies focused on specific types of pain, such as musculoskeletal pain 8, or included specific subtypes of CP, for example bilateral spastic 16, both of which could influence the prevalence rate. Furthermore, we included a wide age span, one to 14 years of age, whereas the other studies focused more on pain in adolescents with CP 6. Our results did indicate that pain prevalence increased with age.…”

Section: Discussionmentioning

confidence: 66%

“…This might be caused by constipation or gastroesophageal reflux, which have been found to be more frequent among those in GMFCS V 24. In other large population‐based studies on older children, headaches seem to have been more frequent than pain in the abdomen 6, which was also in accordance with reports on children and adolescents who did not have CP 19. Except for the lower extremities, there seem to be no clear patterns in terms of where individuals with CP hurt.…”

Section: Discussionmentioning

confidence: 93%

“…In the Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE), a European multinational longitudinal study on CP, 54% of children with CP reported having experienced pain in the previous week and this was also associated with poorer quality of life 4. Pain was even more frequent in a subsequent SPARCLE follow‐up study in adolescence, where 75% of the participants reported that they experienced pain in a typical week and with girls reporting pain more often than boys 6. According to a systematic review on comorbidities, diseases and functional limitations associated with CP, 75% were in pain 9.…”

Section: Introductionmentioning

confidence: 99%

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Pain in children and adolescents with cerebral palsy: a population‐based registry study

2016

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AimWe assessed prevalence and location of pain in a total population of children and adolescents with cerebral palsy (CP) based on the Gross Motor Function Classification System (GMFCS), age and gender.MethodsThis cross‐sectional study was based on the last assessment of children aged 1–14 years in the combined Swedish follow‐up programme and national quality register programme for CP. All were born 2001–2012 and reported to the registry in 2013–2014. Logistic regression was used to regress age, gender and the GMFCS level on the presence of pain. We also assessed pain sites among GMFCS groups.ResultsWe included 2777 children (57% boys) at a median age of 7 years; 32.4% reported pain, with significantly more girls than boys experiencing pain and significantly more children at GMFCS levels III and V than GMFCS I. Pain frequency increased with age and differences among GMFCS levels were found in the lower extremities and abdomen. Pain in the abdomen and hips was most frequent at GMFCS V, knee pain at level III and foot pain at level I.ConclusionOur results showed that although a lower prevalence than in many other studies, pain constituted a significant problem in children and adolescents with CP.

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Neonatal anoxia increases nociceptive response in rats: Sex differences and lumbar spinal cord and insula alterations

Helou

Martins

Arruda

et al. 2021

Intl J of Devlp Neuroscience

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Neonatal anoxia is a well-known world health problem that results in neurodevelopmental deficits, such as sensory alterations that are observed in patients with cerebral palsy and autism disorder, for which oxygen deprivation is a risk factor. Nociceptive response, as part of the sensory system, has been reported as altered in these patients. To determine whether neonatal oxygen deprivation alters nociceptive sensitivity and promotes medium-and long-term inflammatory feedback in the central nervous system, Wistar rats of around 30 h old were submitted to anoxia (100% nitrogen flux for 25 min) and evaluated on PND23 (postpartum day) and PND90. The nociceptive response was assessed by mechanical, thermal, and tactile tests in the early postnatal and adulthood periods. The lumbar spinal cord (SC, L4-L6) motor neurons (MNs) and the posterior insular cortex neurons were counted and compared with their respective controls after anoxia. In addition, we evaluated the possible effect of anoxia on the expression of astrocytes in the SC at adulthood. The results showed increased nociceptive responses in both males and females submitted to anoxia, although these responses were different according to the nociceptive stimulus. A decrease in MNs in adult anoxiated females and an upregulation of GFAP expression in the SC were observed. In the insular cortex, a decrease in the number of cells of anoxiated males was observed in the neonatal period. Our findings suggest that oxygen-deprived nervous systems in rats may affect their response at the sensorimotor pathways and respective controlling centers with sex differences, which were related to the used stimulus.

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Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study

Cited by 145 publications

References 32 publications

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Pain in children and adolescents with cerebral palsy: a population‐based registry study

Neonatal anoxia increases nociceptive response in rats: Sex differences and lumbar spinal cord and insula alterations

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