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Autonomous nervous system regulation of pain in children with cerebral palsy

Inmaculada Riquelme1,2, Raphael Silva do Rosário3, Kari Vehmaskoski4

  • 1University Institute of Health Sciences Research (Iunics-idispa), University of the Balearic Islands, Palma De Mallorca, Spain.

Brain Injury
|March 8, 2021
PubMed

Insights

Children with cerebral palsy (CP) demonstrate intact autonomic nervous system regulation during acute pain events. Heart rate variability (HRV) shows potential as a reliable pain biomarker in children with CP and intellectual disabilities.

Area of Science:

  • Neurology
  • Pediatrics
  • Physiology

Background:

  • Children with cerebral palsy (CP) often experience heightened pain sensitivity and recurrent pain episodes.
  • Pain is frequently underreported in children with intellectual impairments.
  • Autonomic nervous system (ANS) regulation is known to be imbalanced in chronic pain and neurological conditions.

Purpose of the Study:

  • To investigate the ANS regulation of pain in children with CP compared to typically developing peers (TDP).
  • To explore the utility of heart rate variability (HRV) as a pain biomarker in this population.

Main Methods:

  • 24-hour ambulatory heart rate variability (HRV) monitoring was conducted in 26 children with CP and 26 TDP.
  • HRV was analyzed at baseline (rest) and during spontaneous pain episodes.
  • Linear and non-linear HRV indices were computed alongside pain and fatigue assessments.

Main Results:

  • Children with CP exhibited comparable HRV during daily conditions to TDP.
  • Similar reductions in HRV were observed in children with CP after pain events, irrespective of intellectual impairment.
  • Autonomic regulation during acute pain events was found to be intact in children with CP.

Conclusions:

  • Autonomic regulation in response to acute pain is efficient in children with cerebral palsy.
  • Heart rate variability indices show promise as reliable pain biomarkers, even in the presence of intellectual impairment.

Keywords:
Cerebral palsyautonomous nervous systemheart rate variabilityintellectual impairmentpain

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