Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia
•Adults with sickle cell anemia show evidence of central sensitization.•Central sensitization correlated with fetal hemoglobin levels.•Central sensitization could be modulated by fetal hemoglobin induction. Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chr...
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| Veröffentlicht in: | Scandinavian journal of pain 2017-10, Vol.17 (1), p.279-286 |
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| creator | Darbari, Deepika S. Vaughan, Kathleen J. Roskom, Katherine Seamon, Cassie Diaw, Lena Quinn, Meghan Conrey, Anna Schechter, Alan N. Haythornthwaite, Jennifer A. Waclawiw, Myron A. Wallen, Gwenyth R. Belfer, Inna Taylor, James G. |
| description | •Adults with sickle cell anemia show evidence of central sensitization.•Central sensitization correlated with fetal hemoglobin levels.•Central sensitization could be modulated by fetal hemoglobin induction.
Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.
We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.
Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p |
| doi_str_mv | 10.1016/j.sjpain.2017.08.001 |
| format | Article |
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Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.
We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.
Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p<0.0001) and change in scores with temporal summation at the heat pain threshold (p=0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (p=0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512mN) were significantly greater (p=0.004 and p=0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (p=0.002 and 0.003).
Exaggerated temporal summation responses provide evidence of central sensitization in SCA.
The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.</description><identifier>ISSN: 1877-8860</identifier><identifier>EISSN: 1877-8879</identifier><identifier>DOI: 10.1016/j.sjpain.2017.08.001</identifier><identifier>PMID: 28969994</identifier><language>eng</language><publisher>Germany: Elsevier B.V</publisher><subject>Adult ; Anemia, Sickle Cell - blood ; Anemia, Sickle Cell - complications ; Anemia, Sickle Cell - physiopathology ; Central Nervous System Sensitization ; Central sensitization ; Chronic Pain - physiopathology ; Cold Temperature ; Female ; Fetal Hemoglobin ; Hot Temperature ; Humans ; Hyperalgesia ; Male ; Pain ; Pain Threshold ; Prospective Studies ; Sickle cell anemia ; Temporal summation ; Touch</subject><ispartof>Scandinavian journal of pain, 2017-10, Vol.17 (1), p.279-286</ispartof><rights>2017 Scandinavian Association for the Study of Pain</rights><rights>Copyright © 2017 Scandinavian Association for the Study of Pain. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-313cb7b288b375496adfc9b0f2872e636c6d0c85d12c054f6f672109073567793</citedby><cites>FETCH-LOGICAL-c467t-313cb7b288b375496adfc9b0f2872e636c6d0c85d12c054f6f672109073567793</cites><orcidid>0000-0001-7632-8713 ; 0000-0003-2436-2519 ; 0000-0002-4421-1809 ; 0000-0002-3034-5371</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.degruyter.com/document/doi/10.1016/j.sjpain.2017.08.001/pdf$$EPDF$$P50$$Gwalterdegruyter$$H</linktopdf><linktohtml>$$Uhttps://www.degruyter.com/document/doi/10.1016/j.sjpain.2017.08.001/html$$EHTML$$P50$$Gwalterdegruyter$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,66907,68691</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28969994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Darbari, Deepika S.</creatorcontrib><creatorcontrib>Vaughan, Kathleen J.</creatorcontrib><creatorcontrib>Roskom, Katherine</creatorcontrib><creatorcontrib>Seamon, Cassie</creatorcontrib><creatorcontrib>Diaw, Lena</creatorcontrib><creatorcontrib>Quinn, Meghan</creatorcontrib><creatorcontrib>Conrey, Anna</creatorcontrib><creatorcontrib>Schechter, Alan N.</creatorcontrib><creatorcontrib>Haythornthwaite, Jennifer A.</creatorcontrib><creatorcontrib>Waclawiw, Myron A.</creatorcontrib><creatorcontrib>Wallen, Gwenyth R.</creatorcontrib><creatorcontrib>Belfer, Inna</creatorcontrib><creatorcontrib>Taylor, James G.</creatorcontrib><title>Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia</title><title>Scandinavian journal of pain</title><addtitle>Scand J Pain</addtitle><description>•Adults with sickle cell anemia show evidence of central sensitization.•Central sensitization correlated with fetal hemoglobin levels.•Central sensitization could be modulated by fetal hemoglobin induction.
Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.
We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.
Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p<0.0001) and change in scores with temporal summation at the heat pain threshold (p=0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (p=0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512mN) were significantly greater (p=0.004 and p=0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (p=0.002 and 0.003).
Exaggerated temporal summation responses provide evidence of central sensitization in SCA.
The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.</description><subject>Adult</subject><subject>Anemia, Sickle Cell - blood</subject><subject>Anemia, Sickle Cell - complications</subject><subject>Anemia, Sickle Cell - physiopathology</subject><subject>Central Nervous System Sensitization</subject><subject>Central sensitization</subject><subject>Chronic Pain - physiopathology</subject><subject>Cold Temperature</subject><subject>Female</subject><subject>Fetal Hemoglobin</subject><subject>Hot Temperature</subject><subject>Humans</subject><subject>Hyperalgesia</subject><subject>Male</subject><subject>Pain</subject><subject>Pain Threshold</subject><subject>Prospective Studies</subject><subject>Sickle cell anemia</subject><subject>Temporal summation</subject><subject>Touch</subject><issn>1877-8860</issn><issn>1877-8879</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1u1DAUhS0EolXpG1TISzYTbCfjnw0SjGiLVIkNXVuOfdM6OPFgOx2Vp8fTlC7rzb2Lc47P_RC6oKShhPLPY5PHvfFzwwgVDZENIfQNOqVSiI2UQr192Tk5Qec5j-T4BGG8fY9OmFRcKdWdIruDuSQTcIY5--L_muLjjE3O0XpTwOGDL_c4xAMeoFTdPUzxLsTezzjAA4SM62bcEkpepdnb3wGwhRCwmWHy5gN6N5iQ4fx5nqHby--_dtebm59XP3Zfbza246JsWtraXvRMyr4V205x4warejIwKRjwllvuiJVbR5kl227gAxeMEkVEu-VCqPYMfVpz9yn-WSAXPfl87FFrxCVrqjresZpGqrRbpTbFnBMMep_8ZNKjpkQfCetRr4T1kbAmUlfC1fbx-Yeln8C9mP7zrIJvq-BgQoHk4C4tj3XRY1zSXI9_NZ8Kyp7u-LKGVLrw4Ks7Ww-zBecT2KJd9K_X_AdJhKTB</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Darbari, Deepika S.</creator><creator>Vaughan, Kathleen J.</creator><creator>Roskom, Katherine</creator><creator>Seamon, Cassie</creator><creator>Diaw, Lena</creator><creator>Quinn, Meghan</creator><creator>Conrey, Anna</creator><creator>Schechter, Alan N.</creator><creator>Haythornthwaite, Jennifer A.</creator><creator>Waclawiw, Myron A.</creator><creator>Wallen, Gwenyth R.</creator><creator>Belfer, Inna</creator><creator>Taylor, James G.</creator><general>Elsevier B.V</general><general>De Gruyter</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7632-8713</orcidid><orcidid>https://orcid.org/0000-0003-2436-2519</orcidid><orcidid>https://orcid.org/0000-0002-4421-1809</orcidid><orcidid>https://orcid.org/0000-0002-3034-5371</orcidid></search><sort><creationdate>201710</creationdate><title>Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia</title><author>Darbari, Deepika S. ; Vaughan, Kathleen J. ; Roskom, Katherine ; Seamon, Cassie ; Diaw, Lena ; Quinn, Meghan ; Conrey, Anna ; Schechter, Alan N. ; Haythornthwaite, Jennifer A. ; Waclawiw, Myron A. ; Wallen, Gwenyth R. ; Belfer, Inna ; Taylor, James G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-313cb7b288b375496adfc9b0f2872e636c6d0c85d12c054f6f672109073567793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anemia, Sickle Cell - blood</topic><topic>Anemia, Sickle Cell - complications</topic><topic>Anemia, Sickle Cell - physiopathology</topic><topic>Central Nervous System Sensitization</topic><topic>Central sensitization</topic><topic>Chronic Pain - physiopathology</topic><topic>Cold Temperature</topic><topic>Female</topic><topic>Fetal Hemoglobin</topic><topic>Hot Temperature</topic><topic>Humans</topic><topic>Hyperalgesia</topic><topic>Male</topic><topic>Pain</topic><topic>Pain Threshold</topic><topic>Prospective Studies</topic><topic>Sickle cell anemia</topic><topic>Temporal summation</topic><topic>Touch</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Darbari, Deepika S.</creatorcontrib><creatorcontrib>Vaughan, Kathleen J.</creatorcontrib><creatorcontrib>Roskom, Katherine</creatorcontrib><creatorcontrib>Seamon, Cassie</creatorcontrib><creatorcontrib>Diaw, Lena</creatorcontrib><creatorcontrib>Quinn, Meghan</creatorcontrib><creatorcontrib>Conrey, Anna</creatorcontrib><creatorcontrib>Schechter, Alan N.</creatorcontrib><creatorcontrib>Haythornthwaite, Jennifer A.</creatorcontrib><creatorcontrib>Waclawiw, Myron A.</creatorcontrib><creatorcontrib>Wallen, Gwenyth R.</creatorcontrib><creatorcontrib>Belfer, Inna</creatorcontrib><creatorcontrib>Taylor, James G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Scandinavian journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Darbari, Deepika S.</au><au>Vaughan, Kathleen J.</au><au>Roskom, Katherine</au><au>Seamon, Cassie</au><au>Diaw, Lena</au><au>Quinn, Meghan</au><au>Conrey, Anna</au><au>Schechter, Alan N.</au><au>Haythornthwaite, Jennifer A.</au><au>Waclawiw, Myron A.</au><au>Wallen, Gwenyth R.</au><au>Belfer, Inna</au><au>Taylor, James G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia</atitle><jtitle>Scandinavian journal of pain</jtitle><addtitle>Scand J Pain</addtitle><date>2017-10</date><risdate>2017</risdate><volume>17</volume><issue>1</issue><spage>279</spage><epage>286</epage><pages>279-286</pages><issn>1877-8860</issn><eissn>1877-8879</eissn><abstract>•Adults with sickle cell anemia show evidence of central sensitization.•Central sensitization correlated with fetal hemoglobin levels.•Central sensitization could be modulated by fetal hemoglobin induction.
Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.
We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.
Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p<0.0001) and change in scores with temporal summation at the heat pain threshold (p=0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (p=0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512mN) were significantly greater (p=0.004 and p=0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (p=0.002 and 0.003).
Exaggerated temporal summation responses provide evidence of central sensitization in SCA.
The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.</abstract><cop>Germany</cop><pub>Elsevier B.V</pub><pmid>28969994</pmid><doi>10.1016/j.sjpain.2017.08.001</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7632-8713</orcidid><orcidid>https://orcid.org/0000-0003-2436-2519</orcidid><orcidid>https://orcid.org/0000-0002-4421-1809</orcidid><orcidid>https://orcid.org/0000-0002-3034-5371</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anemia, Sickle Cell - blood Anemia, Sickle Cell - complications Anemia, Sickle Cell - physiopathology Central Nervous System Sensitization Central sensitization Chronic Pain - physiopathology Cold Temperature Female Fetal Hemoglobin Hot Temperature Humans Hyperalgesia Male Pain Pain Threshold Prospective Studies Sickle cell anemia Temporal summation Touch |
| title | Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia |
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