Measurement properties of grimace scales for pain assessment in nonhuman mammals: a systematic review

Evangelista, Marina C.; Monteiro, Beatriz P.; Steagall, Paulo V.

doi:10.1097/j.pain.0000000000002474

Cited by 38 publications

(41 citation statements)

References 101 publications

(255 reference statements)

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“…Our findings with grimace scales being among the more frequently used are in line with recent reviews stating that facial expressions are widely used as a pain assessment parameter in laboratory rodents ( 41 , 46 ). In this context, it needs to be emphasized that the analysis of the countries of origin of the first author indicated that we are far from a widespread global application of the parameters of interest.…”

Section: Discussionsupporting

confidence: 91%

“…A scoping review by Whittaker et al examined the MGS in different types of pain (e.g., visceral pain after injection of Freund's adjuvant), indicating a wide application of the MGS in different animal models ( 45 ). A recent scoping review focusing on the grimace scales in non-human mammals has already intensely studied the level of evidence for measurement properties of various grimace scales reporting a high level of evidence for MGS and RGS ( 46 ). Our analysis is more specifically focused on the application of post-operative pain induced by different types of surgeries under general anesthesia in mice and rats, including the extraction of information about anesthesia and perioperative analgesia.…”

Section: Introductionmentioning

confidence: 99%

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Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats—A systematic review

et al. 2022

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Several studies suggested an informative value of behavioral and grimace scale parameters for the detection of pain. However, the robustness and reliability of the parameters as well as the current extent of implementation are still largely unknown. In this study, we aimed to systematically analyze the current evidence-base of grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats. The following platforms were searched for relevant articles: PubMed, Embase via Ovid, and Web of Science. Only full peer-reviewed studies that describe the grimace scale, burrowing, and/or nest building as pain parameters in the post-surgical phase in mice and/or rats were included. Information about the study design, animal characteristics, intervention characteristics, and outcome measures was extracted from identified publications. In total, 74 papers were included in this review. The majority of studies have been conducted in young adult C57BL/6J mice and Sprague Dawley and Wistar rats. While there is an apparent lack of information about young animals, some studies that analyzed the grimace scale in aged rats were identified. The majority of studies focused on laparotomy-associated pain. Only limited information is available about other types of surgical interventions. While an impact of surgery and an influence of analgesia were rather consistently reported in studies focusing on grimace scales, the number of studies that assessed respective effects was rather low for nest building and burrowing. Moreover, controversial findings were evident for the impact of analgesics on post-surgical nest building activity. Regarding analgesia, a monotherapeutic approach was identified in the vast majority of studies with non-steroidal anti-inflammatory (NSAID) drugs and opioids being most commonly used. In conclusion, most evidence exists for grimace scales, which were more frequently used to assess post-surgical pain in rodents than the other behavioral parameters. However, our findings also point to relevant knowledge gaps concerning the post-surgical application in different strains, age levels, and following different surgical procedures. Future efforts are also necessary to directly compare the sensitivity and robustness of different readout parameters applied for the assessment of nest building and burrowing activities.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats—A systematic review

et al. 2022

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“…Unlike in rodent experiments, there are surprisingly few reports measuring pain or nociception in experimental rabbit models, even those modeling knee osteoarthritis or intervertebral disc dislocation (Lei et al, 2017; Mans, 2020; Yoshioka et al, 1996). Composite pain scales for rabbits in a clinical environment (Banchi et al, 2020) and the Bristol Rabbit Pain Scale (Benato et al, 2021) examine and score rabbit facial expressions and other behaviors to assess pain, such as the grimace scale (Evangelista et al, 2021; Keating et al, 2012). Yet, recent reports suggest that the experimenter's presence can have a profound effect on the animal's behavior and subsequent score on these tests (Pinho et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Enhanced nociceptive behavior and expansion of associated primary afferents in a rabbit model of cerebral palsy

Genry

Singer

Cavarsan

et al. 2022

J of Neuroscience Research

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Spastic cerebral palsy (CP) is a movement disorder marked by hypertonia and hyperreflexia; the most prevalent comorbidity is pain. Since spinal nociceptive afferents contribute to both the sensation of painful stimuli as well as reflex circuits involved in movement, we investigated the relationship between prenatal hypoxia-ischemia (HI) injury which can cause CP, and possible changes in spinal nociceptive circuitry. To do this, we examined nociceptive afferents and mechanical and thermal sensitivity of New Zealand White rabbit kits after prenatal HI or a sham surgical procedure. As described previously, a range of motor deficits similar to spastic CP was observed in kits born naturally after HI (40 min at ~70%-80% gestation). We found that HI caused an expansion of peptidergic afferents (marked by expression of calcitonin gene-related peptide) in both the superficial and deep dorsal horn at postnatal day (P)5. Nonpeptidergic nociceptive afferent arborization (labeled by isolectin B4) was unaltered in HI kits, but overlap of the two populations (peptidergic and non-peptidergic nociceptors) was increased by HI. Density of glial fibrillary acidic protein was unchanged within spinal cord white matter regions important in nociceptive transmission at P5.

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“…Unlike in rodent experiments, there are surprisingly few reports measuring pain or nociception in experimental rabbit models, even those modeling knee osteoarthritis or intervertebral disc dislocation (Lei et al, 2017; Mans, 2020; Yoshioka et al, 1996). Composite pain scales for rabbits in a clinical environment (Banchi et al, 2020) and the Bristol Rabbit Pain Scale (Benato et al, 2021) examine and score rabbit facial expressions and other behaviors to assess pain, such as the grimace scale (Evangelista et al, 2021; Keating et al, 2012). Yet, recent reports suggest that the experimenter’s presence can have a profound effect on the animal’s behavior and subsequent score on these tests (Pinho et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Enhanced nociceptive behavior and expansion of associated primary afferents in a rabbit model of cerebral palsy

et al. 2021

Preprint

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The most prevalent comorbidity of cerebral palsy (CP) is pain. In order to investigate the relationship between perinatal injuries that cause CP and nociception, we investigated mechanical and thermal sensitivity of New Zealand White rabbit kits after prenatal hypoxia-ischemia (HI), sham surgery without hypoxia, and after a typical, unperturbed gestation. A range of motor deficits were observed in kits born naturally after HI (40 minutes at 70-80% gestation) as previously described. We found that HI caused mechanical and thermal allodynia at postnatal day 5, which was accompanied by an expansion of peptidergic afferents (marked by expression of calcitonin gene related peptide; CGRP) in both the superficial and deep dorsal horn. Non-peptidergic afferents (marked by expression of isolectin B4; IB4) were unaltered in HI kits but overlap of the two populations (peptidergic and nonpeptidergic nociceptors) was increased by HI. Interestingly, HI-subjected rabbits exhibited allodynia, even in the absence of motor deficits. HI motor affected and unaffected kits had similar thermal sensitivity but affected kits had less mechanical sensitivity than HI unaffected kits. These findings suggest that prenatal neural injuries impact sensory and motor networks independently and that developing sensory circuits may be more vulnerable than motor circuits to perturbation by prenatal hypoxic-ischemic injury. In conclusion, pain experienced by individuals with CP could arise from developmental insults capable of causing the condition, and therapeutics that specifically target altered nociception in these individuals could be beneficial for treating and preventing chronic pain.

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Measurement properties of grimace scales for pain assessment in nonhuman mammals: a systematic review

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 38 publications

References 101 publications

Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats—A systematic review

Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats—A systematic review

Enhanced nociceptive behavior and expansion of associated primary afferents in a rabbit model of cerebral palsy

Enhanced nociceptive behavior and expansion of associated primary afferents in a rabbit model of cerebral palsy

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