Phenotyping peripheral neuropathic pain in male and female adolescents: pain descriptors, somatosensory profiles, conditioned pain modulation, and child–parent reported disability

Abstract

Pain descriptors did not differ between male (n=23) and female (n=43) adolescents with neuropathic pain or CRPS. (A) Total scores on the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS, 0-24) (B) Average pain intensity during the last week reported on a numerical rating scale in the S-LANSS were consistent with measures on a 0-10cm VAS (Fig. 1) and indicated moderate-severe pain in both males and females (C) Total scores for sensory (0-33) and affective (0-12) pain descriptors reported on the McGill Pain Questionnaire were variable but did not differ between males and females. Data points = individual values; bars = median [IQR]. (D) Total S-LANSS scores correlated more strongly with McGill sensory (R 2 =0.22) than affective scores (R 2 =0.11). Data points = individual values. Solid lines=linear regression; dotted lines = 95%CI.

Phenotyping Chronic Musculoskeletal Pain in Male and Female Adolescents: Psychosocial Profiles, Somatosensory Profiles and Pain Modulatory Profiles

“…Somatosensory signs vary within diagnostic characteristics of patients with neuropathic pain, and subgrouping based on different profiles may improve mechanism-based treatment. 16 , 84 In our sample of adolescents with chronic musculoskeletal pain, we also identified distinct sensory loss, thermal hyperalgesia, and mechanical hyperalgesia profiles, but also included a profile in which patients presented QST values closer to “healthy” controls. Although it is important to consider the sample size of our age-matched controls and methodology that may influence the z -scores for some modalities, our results parallel clusters reported in adolescents and adults with neuropathic pain.…”

“…Although it is important to consider the sample size of our age-matched controls and methodology that may influence the z -scores for some modalities, our results parallel clusters reported in adolescents and adults with neuropathic pain. 16 , 77 , 78 Patients without confirmation of a lesion in the somatosensory system but with altered sensory processing may reflect nociplastic pain as the dominant mechanism at play. 85 …”

“…QST parameters were analyzed in accordance with previous studies in adolescents. 16 , 28 Analyses were based on available data, with no imputation for missing data. Descriptive statistics are presented as mean and standard deviation, unless otherwise specified.…”

“…We used a deterministic approach to phenotype our patient cohort using the patient’s somatosensory profile (sensory loss, mechanical hyperalgesia, thermal hyperalgesia or healthy). 16 , 77 , 78 An ANOVA model was then conducted along with a Scheffe test to evaluate the main effect of the patients’ somatosensory profiles using their QST values.…”

“…Moreover, there are limited data evaluating subgroups based on the changes in somatosensory function and pain modulation of pediatric patients with chronic pain conditions. 16 Detailed phenotyping using recommended core outcomes, 17 and tests such as quantitative sensory testing (QST) and conditioned pain modulation (CPM) may provide valuable information for individualized therapy.…”