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Endogenous pain modulation in children with functional abdominal pain disorders
Roselien Pas1,2,3, Emma Rheel1,2, Sophie Van Oosterwijck3,4
1Pain in Motion International Research Group.
Pain
|July 24, 2019
Summary
Young children with functional abdominal pain disorders exhibit heightened pain sensitivity and impaired pain modulation. Their endogenous analgesic systems function less effectively, contributing to their condition.
Area of Science:
- Pediatric Gastroenterology
- Pain Medicine
- Neuroscience
Background:
- Functional abdominal pain disorders (FAPDs) are prevalent in children, yet the underlying pain mechanisms remain poorly understood.
- Endogenous analgesic mechanisms, crucial for pain regulation, have not been extensively studied in pediatric FAPD populations.
Purpose of the Study:
- To compare conditioned pain modulation (CPM) and pressure pain thresholds (PPTs) in children with FAPD versus healthy controls.
- To investigate psychosocial factors, including pain-related fear and parental catastrophizing, in pediatric FAPD.
Main Methods:
- A case-control study involving 39 children with FAPD (aged 6-12) and 36 pain-free controls.
- Utilized pressure algometry for PPTs and the cold pressor task for CPM assessment.
- Employed validated questionnaires for child and parent-reported outcomes.
Main Results:
- Children with FAPD demonstrated significantly lower PPTs across all tested sites, indicating heightened pain sensitivity (secondary hyperalgesia).
- A reduced CPM response was observed in children with FAPD, suggesting impaired endogenous pain inhibition.
- Children with FAPD reported greater functional disability and pain-related fear, with higher parental pain catastrophizing.
Conclusions:
- Pediatric FAPD is associated with altered pain processing, including secondary hyperalgesia and deficient endogenous analgesia.
- Psychosocial factors like pain-related fear and parental catastrophizing are elevated in this population.
- Findings highlight the complex interplay of biological and psychosocial factors in pediatric FAPD.
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