Cargando…
Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery
BACKGROUND: Surgery or multiple procedural interventions in extremely preterm neonates influence neurodevelopmental outcome and may be associated with long-term changes in somatosensory function or pain response. METHODS: This observational study recruited extremely preterm (EP, <26 weeks' g...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200114/ https://www.ncbi.nlm.nih.gov/pubmed/30115261 http://dx.doi.org/10.1016/j.bja.2018.03.035 |
_version_ | 1783365273519128576 |
---|---|
author | Walker, S.M. Melbourne, A. O'Reilly, H. Beckmann, J. Eaton-Rosen, Z. Ourselin, S. Marlow, N. |
author_facet | Walker, S.M. Melbourne, A. O'Reilly, H. Beckmann, J. Eaton-Rosen, Z. Ourselin, S. Marlow, N. |
author_sort | Walker, S.M. |
collection | PubMed |
description | BACKGROUND: Surgery or multiple procedural interventions in extremely preterm neonates influence neurodevelopmental outcome and may be associated with long-term changes in somatosensory function or pain response. METHODS: This observational study recruited extremely preterm (EP, <26 weeks' gestation; n=102, 60% female) and term-born controls (TC; n=48) aged 18–20 yr from the UK EPICure cohort. Thirty EP but no TC participants had neonatal surgery. Evaluation included: quantitative sensory testing (thenar eminence, chest wall); clinical pain history; questionnaires (intelligence quotient; pain catastrophising; anxiety); and structural brain imaging. RESULTS: Reduced thermal threshold sensitivity in EP vs TC participants persisted at age 18–20 yr. Sex-dependent effects varied with stimulus intensity and were enhanced by neonatal surgery, with reduced threshold sensitivity in EP surgery males but increased sensitivity to prolonged noxious cold in EP surgery females (P<0.01). Sex-dependent differences in thermal sensitivity correlated with smaller amygdala volume (P<0.05) but not current intelligence quotient. While generalised decreased sensitivity encompassed mechanical and thermal modalities in EP surgery males, a mixed pattern of sensory loss and sensory gain persisted adjacent to neonatal scars in males and females. More EP participants reported moderate–severe recurrent pain (22/101 vs 4/48; χ(2)=0.04) and increased pain intensity correlated with higher anxiety and pain catastrophising. CONCLUSIONS: After preterm birth and neonatal surgery, different patterns of generalised and local scar-related alterations in somatosensory function persist into early adulthood. Sex-dependent changes in generalised sensitivity may reflect central modulation by affective circuits. Early life experience and sex/gender should be considered when evaluating somatosensory function, pain experience, or future chronic pain risk. |
format | Online Article Text |
id | pubmed-6200114 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-62001142018-10-26 Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery Walker, S.M. Melbourne, A. O'Reilly, H. Beckmann, J. Eaton-Rosen, Z. Ourselin, S. Marlow, N. Br J Anaesth Pain BACKGROUND: Surgery or multiple procedural interventions in extremely preterm neonates influence neurodevelopmental outcome and may be associated with long-term changes in somatosensory function or pain response. METHODS: This observational study recruited extremely preterm (EP, <26 weeks' gestation; n=102, 60% female) and term-born controls (TC; n=48) aged 18–20 yr from the UK EPICure cohort. Thirty EP but no TC participants had neonatal surgery. Evaluation included: quantitative sensory testing (thenar eminence, chest wall); clinical pain history; questionnaires (intelligence quotient; pain catastrophising; anxiety); and structural brain imaging. RESULTS: Reduced thermal threshold sensitivity in EP vs TC participants persisted at age 18–20 yr. Sex-dependent effects varied with stimulus intensity and were enhanced by neonatal surgery, with reduced threshold sensitivity in EP surgery males but increased sensitivity to prolonged noxious cold in EP surgery females (P<0.01). Sex-dependent differences in thermal sensitivity correlated with smaller amygdala volume (P<0.05) but not current intelligence quotient. While generalised decreased sensitivity encompassed mechanical and thermal modalities in EP surgery males, a mixed pattern of sensory loss and sensory gain persisted adjacent to neonatal scars in males and females. More EP participants reported moderate–severe recurrent pain (22/101 vs 4/48; χ(2)=0.04) and increased pain intensity correlated with higher anxiety and pain catastrophising. CONCLUSIONS: After preterm birth and neonatal surgery, different patterns of generalised and local scar-related alterations in somatosensory function persist into early adulthood. Sex-dependent changes in generalised sensitivity may reflect central modulation by affective circuits. Early life experience and sex/gender should be considered when evaluating somatosensory function, pain experience, or future chronic pain risk. Elsevier 2018-09 2018-06-19 /pmc/articles/PMC6200114/ /pubmed/30115261 http://dx.doi.org/10.1016/j.bja.2018.03.035 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Pain Walker, S.M. Melbourne, A. O'Reilly, H. Beckmann, J. Eaton-Rosen, Z. Ourselin, S. Marlow, N. Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title | Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title_full | Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title_fullStr | Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title_full_unstemmed | Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title_short | Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery |
title_sort | somatosensory function and pain in extremely preterm young adults from the uk epicure cohort: sex-dependent differences and impact of neonatal surgery |
topic | Pain |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200114/ https://www.ncbi.nlm.nih.gov/pubmed/30115261 http://dx.doi.org/10.1016/j.bja.2018.03.035 |
work_keys_str_mv | AT walkersm somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT melbournea somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT oreillyh somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT beckmannj somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT eatonrosenz somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT ourselins somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery AT marlown somatosensoryfunctionandpaininextremelypretermyoungadultsfromtheukepicurecohortsexdependentdifferencesandimpactofneonatalsurgery |