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Conditioned pain modulation identifies altered sensitivity in extremely preterm young adult males and females

S M Walker1, H O'Reilly2, J Beckmann2

  • 1Clinical Neurosciences (Pain Research), UCL Great Ormond Street Institute of Child Health, London, UK; Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

British Journal of Anaesthesia
|August 18, 2018
PubMed

Insights

Extremely preterm birth did not alter conditioned pain modulation (CPM) in young adults. However, some extremely preterm females showed increased pain sensitivity, suggesting early-life factors and sex influence persistent pain risk.

Area of Science:

  • Neuroscience
  • Pain Research
  • Developmental Biology

Background:

  • Conditioned pain modulation (CPM) is a potential biomarker for persistent pain risk.
  • Early-life experiences can significantly impact somatosensory processing and pain responses.
  • The effect of extremely preterm birth on CPM has not been previously evaluated.

Purpose of the Study:

  • To evaluate conditioned pain modulation (CPM) in young adults who were born extremely preterm.
  • To compare CPM between extremely preterm and term-born individuals.
  • To identify potential sex-specific differences in pain modulation after extremely preterm birth.

Main Methods:

  • An observational study involving extremely preterm (<26 weeks gestation) and term-born control young adults (19-20 years).
  • Measurement of pressure pain threshold (PPT) before, during, and after a cold conditioning stimulus (hand immersion).
  • Assessment of current pain, medication use, anxiety, and pain catastrophizing via questionnaires.

Main Results:

  • The conditioned pain modulation (CPM) effect did not significantly differ between extremely preterm and term-born groups.
  • A higher proportion of extremely preterm participants experienced reduced cold tolerance, hindering CPM quantification.
  • Extremely preterm females exhibited lower baseline PPT and a tendency to withdraw from the conditioning stimulus more readily than controls.

Conclusions:

  • Cold conditioning successfully evoked inhibitory modulation in most participants.
  • Extremely preterm birth did not alter the overall CPM response, but identified a subgroup of females with heightened baseline pain sensitivity.
  • Sex and early-life experiences are crucial factors to consider when assessing persistent pain risk using CPM.
Abstract

Keywords:
conditioned pain modulationextremely prematureinfantpain

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