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Kaplan CM, Kelleher E, Irani A, Schrepf A, Clauw DJ, Harte SE. Deciphering nociplastic pain: clinical features, risk factors and potential mechanisms. Nat Rev Neurol 2024; 20:347-363. [PMID: 38755449 DOI: 10.1038/s41582-024-00966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Nociplastic pain is a mechanistic term used to describe pain that arises or is sustained by altered nociception, despite the absence of tissue damage. Although nociplastic pain has distinct pathophysiology from nociceptive and neuropathic pain, these pain mechanisms often coincide within individuals, which contributes to the intractability of chronic pain. Key symptoms of nociplastic pain include pain in multiple body regions, fatigue, sleep disturbances, cognitive dysfunction, depression and anxiety. Individuals with nociplastic pain are often diffusely tender - indicative of hyperalgesia and/or allodynia - and are often more sensitive than others to non-painful sensory stimuli such as lights, odours and noises. This Review summarizes the risk factors, clinical presentation and treatment of nociplastic pain, and describes how alterations in brain function and structure, immune processing and peripheral factors might contribute to the nociplastic pain phenotype. This article concludes with a discussion of two proposed subtypes of nociplastic pain that reflect distinct neurobiological features and treatment responsivity.
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Affiliation(s)
- Chelsea M Kaplan
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Eoin Kelleher
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Anushka Irani
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Division of Rheumatology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Andrew Schrepf
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel J Clauw
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Steven E Harte
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
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Hollund IMH, Aakvik KAD, Benum SD, Ingvaldsen SH, Lydersen S, Tikanmäki M, Hovi P, Räikkönen K, Kajantie E, Johnson S, Marlow N, Baumann N, Wolke D, Indredavik MS, Evensen KAI. Mental health, pain and tiredness in adults born very preterm or with very low birthweight. Acta Paediatr 2024; 113:72-80. [PMID: 37787099 DOI: 10.1111/apa.16982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023]
Abstract
AIM Adults born preterm have increased risk of mental health problems and other neurodevelopmental conditions. We aimed to investigate associations of mental health with pain and tiredness in adults born very preterm (VP; <32 weeks) or very low birthweight (VLBW; <1500 g) and at term, and whether these associations are influenced by physical activity. METHODS As part of an EU Horizon 2020 project, individual participant data from six prospective cohort studies were harmonised for 617 VP/VLBW and 1122 term-born participants. Mental health was assessed by the Achenbach System of Empirically Based Assessment Adult Self-Report. Pain and tiredness were harmonised based on specific items from self-reported questionnaires. Associations between mental health and pain or tiredness were explored by linear regression. RESULTS An increase in the mental health scales internalising, externalising and total problems was associated with increased pain and tiredness in the preterm and term group alike. Results were maintained when adjusting for physical activity. CONCLUSION The findings indicate that associations between mental health, pain and tiredness in adults are independent of gestation or birthweight. Future research should explore other potential mechanisms that may underlie the increased risk of mental health problems in the preterm population.
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Affiliation(s)
- Ingrid Marie Husby Hollund
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marjaana Tikanmäki
- Clinical Medicine Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
| | - Petteri Hovi
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Medicine Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Samantha Johnson
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK
| | - Nicole Baumann
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Psychology, University of Warwick, Coventry, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Evensen KAI, Aakvik KAD, Hollund IMH, Skranes J, Brubakk A, Indredavik MS. Multidisciplinary and neuroimaging findings in preterm born very low birthweight individuals from birth to 28 years of age: A systematic review of a Norwegian prospective cohort study. Paediatr Perinat Epidemiol 2022; 36:606-630. [PMID: 35867340 PMCID: PMC9542186 DOI: 10.1111/ppe.12890] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Children born preterm with very low birthweight (VLBW) face long-lasting neurodevelopmental challenges, where multidisciplinary assessments are warranted. The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding and conceptualising these outcomes. OBJECTIVES We aimed to review clinical and neuroimaging findings from birth to adulthood in a Norwegian cohort of individuals born preterm with VLBW (gestational age <37 weeks, birthweight ≤1500 g) within the framework of ICF. DATA SOURCES We searched PubMed and Embase for articles reporting results of the Norwegian University of Science and Technology (NTNU) Low Birth Weight in a Lifetime Perspective study. STUDY SELECTION AND DATA EXTRACTION We included original articles reporting proportions of adverse outcomes, mean group differences, risk factors or associations between outcomes. Data were extracted according to ICF's two-level classification. Body functions and structures comprised outcomes of brain structures, cognition, mental health, vision, pain and physical health. Activities and participation comprised motor skills, general and social functioning, education, employment, and health-related quality of life. SYNTHESIS We performed a qualitative synthesis of included articles. Where mean (SD) was reported, we calculated group differences in SD units. RESULTS Fifty-eight publications were included. Within body functions and structures, increased prevalence of brain structure pathology, lower cognitive performance, mental health problems, visual and physical health impairments through childhood, adolescence and young adulthood were reported among preterm VLBW participants compared with controls. Within activities and participation, motor problems, lower general and social functioning, and lower academic attainment were found. Perinatal factors were associated with several outcomes, and longitudinal findings suggested persistent consequences of being born preterm with VLBW. CONCLUSIONS Being born preterm with VLBW has long-term influences on body functions and structures, activities and participation. The ICF is appropriate for assessing general domains of functioning and guiding the management of individuals born preterm with VLBW.
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Affiliation(s)
- Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of Physiotherapy, Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway,Unit for Physiotherapy ServicesTrondheim MunicipalityTrondheimNorway
| | - Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Ingrid Marie Husby Hollund
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of Physical Medicine and RehabilitationSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of PediatricsSørlandet HospitalArendalNorway
| | - Ann‐Mari Brubakk
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
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Lund CI, Engdahl B, Rosseland LA, Stubhaug A, Grimnes G, Furberg AS, Steingrímsdóttir ÓA, Nielsen CS. The association between age at menarche and chronic pain outcomes in women: the Tromsø Study, 2007 to 2016. Pain 2022; 163:1790-1799. [PMID: 35239542 PMCID: PMC9393800 DOI: 10.1097/j.pain.0000000000002579] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 12/03/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Sex differences in chronic pain are well established with documented predominance in women. This study assessed relationships between age at menarche and chronic pain, site-specific chronic pain, pain characteristics, and chronic widespread pain (CWP). We used data from the Tromsø Study conducted in 2007 to 2008 and 2015 to 2016 (Tromsø 6 and Tromsø 7 waves) including participants aged 30 to 99 years. The associations between age at menarche and chronic pain were examined in Tromsø 6 (n = 6449), Tromsø 7 (n = 5681), and the combination of Tromsø 6 and Tromsø 7 (n = 12,130). Tromsø 7 data were used further to examine the associations between age at menarche and site-specific chronic pain, 4 pain characteristics (pain duration, pain intensity, episode duration, and episode frequency), and CWP. All analyses were adjusted for body mass index, age, and economic status of the household in childhood. Lower age at menarche was associated with an increased risk of chronic pain in all 3 samples (risk ratio for each year delay in menarche 0.98, 95% CI [0.97 to 0.99] across samples). Risk differences were -0.014, CI 95% (-0.02 to -0.005) in Tromsø 6, -0.011, CI 95% (-0.02 to -0.02) in Tromsø 7, and -0.012, CI 95% (-0.02 to -0.01) in the combined sample. Age at menarche was significantly associated with chronic pain in the neck, abdomen, and both arms, and CWP. Of the 4 pain characteristics, pain duration was statistically significant. We conclude that early menarche is an independent risk factor for pain across a broad spectrum of pain outcomes.
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Affiliation(s)
- Charlotte I. Lund
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bo Engdahl
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Leiv A. Rosseland
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Guri Grimnes
- Division of Clinical Medicine, University Hospital of North Norway, Tromsø, Norway
- Institute of Clinical Medicine, UiT—the Arctic University of Norway, Tromsø, Norway
| | - Anne-Sofie Furberg
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Ólöf A. Steingrímsdóttir
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Christopher S. Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
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van Dokkum NH, de Kroon MLA, Reijneveld SA, Bos AF. Self‐reported sensitivity to pain in early and moderately‐late preterm‐born adolescents: A community‐based cohort study. PAEDIATRIC AND NEONATAL PAIN 2021; 3:59-67. [PMID: 35547596 PMCID: PMC8975215 DOI: 10.1002/pne2.12053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/12/2021] [Accepted: 04/25/2021] [Indexed: 11/07/2022]
Abstract
We aimed to compare ratings of self‐reported and parent‐reported pain sensitivity between early preterm (EP), moderately‐late preterm (MLP), and full‐term (FT) adolescents. For EP adolescents, we aimed to determine whether pain sensitivity was associated with early‐life events. EP (n = 68, response rate 47.4%), MLP (n = 128, response rate 33.0%), and FT (n = 78, response rate 31.1%) adolescents and their parents (n = 277) answered an author‐generated question on pain sensitivity at 14‐15 years of age within a community‐based cohort study. Differences between groups were determined using the chi‐square test for trends. For EP adolescents, we assessed associations of treatment modalities (inotrope treatment, mechanical ventilation, and C‐section) and neonatal morbidities (sepsis/necrotizing enterocolitis, small‐for‐gestational age status, asphyxia, and cerebral pathologies) with adolescent pain sensitivity using logistic regression analyses. Increased pain sensitivity was reported by 18% of EP adolescents, compared with 12% of MLP adolescents, and 7% of FT adolescents (P = 0.033). Parent‐reported pain sensitivity did not differ by gestational age group. For EP adolescents, inotrope treatment was associated with increased pain sensitivity (odds ratio, 5.00, 95% confidence interval, 1.23‐20.4, P = 0.025). No other neonatal treatment modalities or morbidities were associated with pain sensitivity in adolescence. In conclusion, we observed higher proportions of increased pain sensitivity for EP and MLP adolescents. Physicians treating preterm adolescents should be aware of altered pain sensitivity.
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Affiliation(s)
- Nienke H. van Dokkum
- Department of PediatricsDivision of NeonatologyBeatrix Children’s Hospital, University Medical Center Groningen, University of GroningenGroningenthe Netherlands
- Department of Health SciencesUniversity Medical Center Groningen, University of GroningenGroningenthe Netherlands
| | - Marlou L. A. de Kroon
- Department of Health SciencesUniversity Medical Center Groningen, University of GroningenGroningenthe Netherlands
| | - Sijmen A. Reijneveld
- Department of Health SciencesUniversity Medical Center Groningen, University of GroningenGroningenthe Netherlands
| | - Arend F. Bos
- Department of PediatricsDivision of NeonatologyBeatrix Children’s Hospital, University Medical Center Groningen, University of GroningenGroningenthe Netherlands
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Brown D, Schenk S, Genent D, Zernikow B, Wager J. A scoping review of chronic pain in emerging adults. Pain Rep 2021; 6:e920. [PMID: 34712883 PMCID: PMC8546842 DOI: 10.1097/pr9.0000000000000920] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/06/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022] Open
Abstract
Much of the adult chronic pain literature addresses pain in typical pain cohorts of middle-aged to older individuals. To date, little research has focused on chronic pain in younger adults, who likely have a completely different pain experience. This scoping review aimed to address this gap by describing the emerging adult (18-29 years) chronic pain experience regarding prevalence, associated factors, outcomes, and pain management. Searches of primary electronic databases including PubMed, Embase, PsycINFO, and CINAHL were performed on February 26, 2020, restricting the publication date from database inception to December 31, 2019. The search strategy, conducted in English, covered search term combinations of "chronic pain" and "young adults." A total of 6,612 records were considered-3,141 after removing duplicates. These records were screened by title and abstract; 871 through full-text screening. Of these, 78 articles covered the topic of emerging adults with chronic pain. Collectively, results indicated that between 5% and 30% of emerging adults experience chronic pain, depending on the sample and exact chronic pain definition. The most consistent associated factors were female sex, familial chronic pain, and previous experiences of chronic pain in childhood. Anxiety, depression, and sleep issues appeared associated both before and after the onset of chronic pain. Outcomes of pain included interruptions to study and work, poorer physical functioning, and pain-related interference to socializing. We observed that few pain treatments have been tested specifically in this cohort. A greater ongoing focus on chronic pain in emerging adults is required to improve long-lasting outcomes.
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Affiliation(s)
- Donnamay Brown
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Germany
| | - Sabrina Schenk
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Germany
| | - Dunja Genent
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Germany
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Germany
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Strang-Karlsson S, Alenius S, Näsänen-Gilmore P, Nurhonen M, Haaramo P, Evensen KAI, Vääräsmäki M, Gissler M, Hovi P, Kajantie E. Migraine in children and adults born preterm: A nationwide register linkage study. Cephalalgia 2020; 41:677-689. [PMID: 33297743 DOI: 10.1177/0333102420978357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Being born preterm is related to adverse health effects later in life. We studied whether preterm birth predicts the risk of migraine. METHODS In this nationwide register study, we linked data from six administrative registers for all 235,624 children live-born in Finland (January 1987 to September 1990) and recorded in the Finnish Medical Birth Register. n = 228,610 (97.0%) had adequate data and were included. Migraine served as primary outcome variable and was stringently defined as a diagnosis from specialised health care and/or ≥2 reimbursed purchases of triptans. We applied sex- and birth year-stratified Cox proportional hazard regression models to compute hazard ratios and confidence intervals (95% confidence intervals) for the association between preterm categories and migraine. The cohort was followed up until an average age of 25.1 years (range: 23.3-27.0). RESULTS Among individuals born extremely preterm (23-27 completed weeks of gestation), the adjusted hazard ratios for migraine was 0.55 (0.25-1.24) when compared with the full-term reference group (39-41 weeks). The corresponding adjusted hazard ratios and 95% confidence intervals for the other preterm categories were: Very preterm (28-31 weeks); 0.95 (0.68-1.31), moderately preterm (32-33 weeks); 0.96 (0.73-1.27), late preterm (34-36 weeks); 1.01 (0.91-1.11), early term (37-38 weeks); 0.98 (0.93-1.03), and post term (42 weeks); 0.98 (0.89-1.08). Migraine was predicted by parental migraine, lower socioeconomic position, maternal hypertensive disorder and maternal smoking during pregnancy. CONCLUSION We found no evidence for a higher risk of migraine among individuals born preterm.
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Affiliation(s)
- Sonja Strang-Karlsson
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Clinical Genetics, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suvi Alenius
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pieta Näsänen-Gilmore
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Global Health group, University of Tampere, Tampere, Finland
| | | | - Peija Haaramo
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway.,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Marja Vääräsmäki
- Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
| | - Petteri Hovi
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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9
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Lærum AMW, Reitan SK, Evensen KAI, Lydersen S, Brubakk AM, Skranes J, Indredavik MS. Psychiatric symptoms and risk factors in adults born preterm with very low birthweight or born small for gestational age at term. BMC Psychiatry 2019; 19:223. [PMID: 31315591 PMCID: PMC6636134 DOI: 10.1186/s12888-019-2202-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/02/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We aimed to examine psychiatric symptoms in adults born preterm with very low birthweight or born at term small for gestational age compared with normal birthweight peers, and examine associations with perinatal factors and childhood motor and cognitive function. METHODS In this longitudinal cohort study, one preterm born group with very low birthweight (VLBW: birthweight ≤1500 g), one term-born Small for Gestational Age (SGA: birthweight <10th percentile) group and one term-born non-SGA control group, were assessed at 26 years of age. Primary outcomes were scores on self-reported questionnaires: Achenbach System of Empirically Based Assessment - Adult Self-Report, The Autism-Spectrum Quotient and Peters et al. Delusions Inventory. Exposure variables were perinatal data, while childhood motor and cognitive function were examined as possible early markers. RESULTS Both the preterm VLBW and the term SGA group reported higher levels of attention, internalizing and externalizing problems compared to the control group. In addition, the VLBW participants reported more critical items and a higher proportion had intermediate level autistic traits, while the SGA participants reported more intrusive behavior. Increasing length of respiratory support and hospital stay in the neonatal period, and motor problems in early adolescence, were associated with adult psychiatric symptoms in the VLBW group. CONCLUSIONS Psychiatric symptoms were frequent in the preterm VLBW group and also in the term-born SGA group. Those who were sickest as babies were most at risk. Motor problems can possibly serve as an early marker of adult psychiatric symptoms in low birthweight individuals.
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Affiliation(s)
- Astrid M. W. Lærum
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Solveig Klæbo Reitan
- 0000 0001 1516 2393grid.5947.fDepartment of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Department of Mental Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kari Anne I. Evensen
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0001 1516 2393grid.5947.fDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,Unit for Physiotherapy Services, Trondheim Municipality, Norway ,Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Stian Lydersen
- 0000 0001 1516 2393grid.5947.fDepartment of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jon Skranes
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0414 4503grid.414311.2Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Marit S. Indredavik
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway
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10
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Nilsson I, Brogårdh‐Roth S, Månsson J, Ekberg E. Temporomandibular pain in adolescents with a history of preterm birth. J Oral Rehabil 2019; 46:589-596. [DOI: 10.1111/joor.12782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/21/2018] [Accepted: 02/21/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Ing‐Marie Nilsson
- Center for Oral Rehabilitation Norrköping Sweden
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology Malmö University Malmö Sweden
| | - Susanne Brogårdh‐Roth
- Department of Paediatric Dentistry, Faculty of Odontology Malmö University Malmö Sweden
| | | | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology Malmö University Malmö Sweden
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11
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Siqueira FCM, Ferreira PH, Dario AB, Harmer A, Oliveira VC, Leite HR. Are perinatal factors associated with musculoskeletal pain across the lifespan? A systematic review with meta-analysis. Musculoskelet Sci Pract 2019; 39:170-177. [PMID: 30360956 DOI: 10.1016/j.msksp.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/25/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Musculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. OBJECTIVE To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. METHODS MEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to "perinatal factors" and "musculoskeletal pain". There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. RESULTS Among the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9-3.8, I2 = 0; n = 157) or pre-term birth (OR 0.5, 95% CI 0.0-4.5; I2 = 78%; n = 374) in adults, respectively. Overall, the quality of evidence after applying the GRADE approach was very low across all the studies. CONCLUSION In adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.
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Affiliation(s)
- Fernando C M Siqueira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Amabile B Dario
- Faculty of Health Sciences, The University of Sydney, Australia
| | - Alison Harmer
- Faculty of Health Sciences, The University of Sydney, Australia
| | - Vinicius Cunha Oliveira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Hercules Ribeiro Leite
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Faculty of Health Sciences, The University of Sydney, Australia.
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12
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Leite HR, Dario AB, Harmer AR, Oliveira VC, Ferreira ML, Calais-Ferreira L, Ferreira PH. Contributions of birthweight, annualised weight gain and BMI to back pain in adults: a population-based co-twin control study of 2754 Australian twins. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 28:224-233. [PMID: 30523461 DOI: 10.1007/s00586-018-5850-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight. METHODS The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total sample; within-pair case-control for monozygotic and dizygotic twins together; and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI). RESULTS Birthweight was not associated with back pain (OR 0.99; 95% CI 0.99-1.00), but a weak association was found between weight gain (OR 1.01; CI 1.00-1.01) or current BMI (OR 1.02; 95% CI 1.00-1.05) and back pain in the total sample analysis. These associations did not remain significant after adjusting for genetics. The associations did not differ between those whose were born with low or full birthweight. CONCLUSION Birthweight was not associated with prevalence of back pain in adulthood. Weight gain and current BMI were weakly associated with back pain prevalence in the total sample analysis but did not differ between those born with low or full birthweight. However, the small-magnitude association only just achieved significance and appeared to be confounded by genetics and the early shared environment. Our results suggest that a direct link between these predictors and back pain in adults is unlikely. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Hercules R Leite
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, Australia.
| | - Amabile B Dario
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, Australia
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, Australia
| | - Vinicius C Oliveira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Lucas Calais-Ferreira
- Twins Research Australia, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Paulo H Ferreira
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, Australia
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13
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Evensen KAI, Tikanmäki M, Heinonen K, Matinolli HM, Sipola-Leppänen M, Lano A, Wolke D, Vääräsmäki M, Eriksson JG, Andersson S, Järvelin MR, Hovi P, Räikkönen K, Kajantie E. Musculoskeletal pain in adults born preterm: Evidence from two birth cohort studies. Eur J Pain 2018; 23:461-471. [DOI: 10.1002/ejp.1320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 09/05/2018] [Accepted: 09/28/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine; Norwegian University of Science and Technology; Trondheim Norway
- Department of Public Health and Nursing; Norwegian University of Science and Technology; Trondheim Norway
- Department of Physiotherapy; Trondheim Municipality; Trondheim Norway
| | - Marjaana Tikanmäki
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- Institute of Health Sciences; University of Oulu; Oulu Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics; University of Helsinki; Helsinki Finland
| | - Hanna-Maria Matinolli
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- Department of Nursing Science; University of Turku; Turku Finland
| | - Marika Sipola-Leppänen
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- Institute of Health Sciences; University of Oulu; Oulu Finland
- PEDEGO Research Unit (Research Unit for Pediatrics; Dermatology, Clinical Genetics, Obstetrics and Gynecology); Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
| | - Aulikki Lano
- Children's Hospital; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - Dieter Wolke
- Department of Psychology; University of Warwick; Coventry UK
| | - Marja Vääräsmäki
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- PEDEGO Research Unit (Research Unit for Pediatrics; Dermatology, Clinical Genetics, Obstetrics and Gynecology); Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
| | - Johan G. Eriksson
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- Department of General Practice and Primary Health Care; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Folkhälsan Research Center; Helsinki Finland
| | - Sture Andersson
- Children's Hospital; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences; University of Oulu; Oulu Finland
- Department of Epidemiology and Biostatistics; Imperial College; London UK
| | - Petteri Hovi
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics; University of Helsinki; Helsinki Finland
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine; Norwegian University of Science and Technology; Trondheim Norway
- Department of Public Health Solutions; National Institute for Health and Welfare; Oulu and Helsinki Finland
- PEDEGO Research Unit (Research Unit for Pediatrics; Dermatology, Clinical Genetics, Obstetrics and Gynecology); Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
- Children's Hospital; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
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14
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Walker SM, 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. Br J Anaesth 2018; 121:623-635. [PMID: 30115261 PMCID: PMC6200114 DOI: 10.1016/j.bja.2018.03.035] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/27/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022] Open
Abstract
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; χ2=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.
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Affiliation(s)
- S M Walker
- Clinical Neurosciences (Pain Research), UCL Great Ormond Street Institute of Child Health, London, UK; Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
| | - A Melbourne
- Translational Imaging Group, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - H O'Reilly
- Academic Neonatology, EGA UCL Institute for Women's Health, London, UK
| | - J Beckmann
- Academic Neonatology, EGA UCL Institute for Women's Health, London, UK
| | - Z Eaton-Rosen
- Translational Imaging Group, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - S Ourselin
- Translational Imaging Group, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - N Marlow
- Academic Neonatology, EGA UCL Institute for Women's Health, London, UK
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15
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Pain Sensitivity and Thermal Detection Thresholds in Young Adults Born Preterm With Very Low Birth Weight or Small for Gestational Age at Term Compared With Controls. THE JOURNAL OF PAIN 2018; 19:873-884. [DOI: 10.1016/j.jpain.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/10/2018] [Accepted: 03/01/2018] [Indexed: 11/22/2022]
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16
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Conditioned pain modulation identifies altered sensitivity in extremely preterm young adult males and females. Br J Anaesth 2018; 121:636-646. [PMID: 30115262 PMCID: PMC6200113 DOI: 10.1016/j.bja.2018.05.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/28/2018] [Accepted: 06/08/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Conditioned pain modulation is a potential biomarker for risk of persistent pain. As early-life experience can alter subsequent somatosensory processing and pain response, we evaluated conditioned pain modulation after extremely preterm birth. METHODS This observational study recruited extremely preterm (<26 weeks gestation; n=98) and term-born control (n=48) young adults (19-20 yr) from the longitudinal EPICure cohort. Pressure pain threshold (PPT; variable test stimulus lower leg) was measured before, during, and after a conditioning stimulus (contralateral hand immersion; 5°C water; 30 s). Questionnaires assessed current pain, medication use, anxiety, and pain catastrophising. RESULTS For participants tolerating conditioning, there were significant main effects of extremely preterm status, sex, and time on PPT during and after hand immersion. Inhibitory modulation was evoked in 64/98 extremely preterm (3, no change) and 38/48 term-born control (3, facilitation) subjects. The conditioned pain modulation effect (percentage change in PPT) did not differ between the extremely preterm and term-born control groups {53% [95% confidence interval (CI): 41-65] vs 57% [95% CI: 42-71]}. Reduced cold tolerance (<20 s) hampered conditioned pain modulation quantification in a higher proportion of extremely preterm participants [extremely preterm vs term-born control: 31/98 (32%) vs 7/48 (15%); P=0.03]. One-third of extremely preterm females withdrew the hand before parallel PPT (<15 s), and had lower baseline PPT than term-born control females [4.9 (95% CI: 4.8-5.1) vs 5.3 (95% CI: 5.1-5.5) ln kPa; P=0.02]. Higher anxiety, pain catastrophising, and medication use correlated with pain intensity, but not conditioned pain modulation effect. CONCLUSIONS Cold conditioning evoked inhibitory modulation in the majority of young adults and identified a subgroup of extremely preterm females with increased baseline sensitivity. Early-life experience and sex/gender should be considered when evaluating persistent pain risk with conditioned pain modulation.
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