Advancing the Measurement of Executive Functioning in Pediatric Chronic Pain

Beckmann, E.; Mano, Kristen E. Jastrowski

doi:10.3390/children8080630

Cited by 6 publications

(1 citation statement)

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“…We speculate that a child's early reports of pain likely warranted careful focus, specifically in relation to difficulties with attention or psychological presentation in general. Chronic pain has an interruptive effect on executive functioning, which, in school-age children, is frequently manifested in academic settings (23,24). As such, pediatric pain may, in some instances, be the hidden cause behind behavioral (25,26) hypothesized that early exposure to pain may redirect neurodevelopment in a way that renders an individual vulnerable to pain.…”

Section: Discussionmentioning

confidence: 99%

Case report: Chronic pain in a pediatric patient with late-onset pompe disease

Cao,

van Gool,

Golden

et al. 2023

Front. Pain Res.

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Pompe disease (PD) is a rare inherited metabolic disorder of deficient or absent acid alpha-glucosidase (GAA), resulting in defective lysosomal glycogen catabolism. Muscle weakness, respiratory deficiency and gastrointestinal symptoms are commonly monitored in PD. However, pain and associated psychological symptoms are less focused upon. A pediatric patient with late-onset Pompe disease (LOPD) comorbid with chronic pain is presented. Symptoms of pain in the feet were first reported between 6 and 7 years of age and were attributed to growing pains. Following progression of lower body pain, weakness, fatigue, and difficulties with ambulation, a thorough clinical assessment including genetic testing was performed, which led to a diagnosis of LOPD at 9 years of age. ERT with recombinant human alglucosidase alfa was subsequently started. The patient’s clinical status is compounded by depressed mood, anxiety, and attention deficit hyperactivity disorder, which may further exacerbate pain. A multidisciplinary pain treatment approach consisting of orthopedics, physical therapy, and psychosocial therapy aimed at enhancing pain coping skills is described for this LOPD patient. This case highlights the need for a greater understanding of pain generation and identification of optimized pain treatment approaches in children with LOPD that can be implemented alongside ERT.

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Section: Discussionmentioning

confidence: 99%

Case report: Chronic pain in a pediatric patient with late-onset pompe disease

Cao,

van Gool,

Golden

et al. 2023

Front. Pain Res.

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Chronic Pain: Utility of an Eye-Tracker Integrated Stand-alone Performance Validity Test

Braw,

Elbaum,

Lupu

et al. 2024

Psychol. Inj. and Law

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Noncredible cognitive performance among chronic pain patients garners increased clinical attention. The Word Memory Test (WMT)—a well-established stand-alone validity indicator—was recently integrated with an eye tracker, and its utility was assessed using healthy simulators. The current study expands on this earlier work by assessing the utility of the eye-tracker integrated WMT to detect noncredible cognitive performance in the context of chronic pain. Chronic pain outpatients were randomly assigned to either a simulation (i.e., patients simulating cognitive impairment; n = 22) or honest control (i.e., patients performing to the best of their ability; n = 23) conditions. They then completed the WMT’s immediate recognition (IR) subtest while their eye movements were recorded. Simulators gazed less at relevant stimuli and gazed more at irrelevant stimuli than controls. Sensitivity levels tended to be low to moderate when maintaining specificities ≥ 90%, as customary in the field. While a previously developed scale that integrates eye movement measures using a logistic regression did not adequately differentiate the groups, conjunctive rules (i.e., the participant was required to fail both the WMT's classification scheme and the eye movement measure with the strongest discriminative capacity) were associated with higher specificities than those of the WMT’s conventional classification scheme. Overall, the eye-tracker integrated WMT shows initial clinical utility for detecting noncredible cognitive performance. Decreasing costs of eye trackers and enhanced usability will hopefully encourage further research of their utility for detecting noncredible cognitive performance and integration of this novel technology with other stand-alone validity indicators.

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