Highlights
- •Pain sensitivity in sickle cell disease (SCD) is influenced by psychological factors.
- •Frequency of pain episodes also influences pain sensitivity in SCD.
- •Age- and gender-based normative data on pain sensitivity should be used to define impaired pain sensitivity in SCD.
Abstract
Sickle cell disease (SCD) is associated with episodes of severe vaso-occlusive pain
beginning in infancy with a subset of patients with SCD transitioning to chronic pain.
Response to experimental pain using quantitative sensory testing in these patients
suggests altered pain processing. The objectives of this study were to characterize
sensitivity to multiple modalities of experimental pain stimuli and to interrogate
the relationship of psychological covariates, clinical pain burden, and pain-related
outcomes to experimental pain sensitivity in children with SCD compared with healthy
individuals of similar age and sex. Cross-sectional assessments of psychological characteristics
were performed, and quantitative sensory testing methods were used to measure experimental
pain sensitivity in children age 8 to 21 years. Anxiety, depressive symptoms, catastrophizing,
and somatization were found to be associated with increased sensitivity to experimental
pain stimuli. Increased frequency of painful episodes in SCD was associated with decreased
sensitivity to heat pain and decreased mechanical temporal summation. These data suggest
that careful consideration be given to psychological factors, age, sex, and clinical
burden of pain when studying response to experimental pain in SCD.
Perspective
In this study of patients with SCD, a condition associated with recurrent acute or
chronic pain, psychological factors such as depression, anxiety, and catastrophizing
are associated with increased sensitivity to experimental pain stimuli. Further study
is need to delineate the role of these factors in chronic SCD pain.
Key words
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Article info
Publication history
Published online: June 05, 2017
Accepted:
May 6,
2017
Received in revised form:
April 20,
2017
Received:
November 10,
2016
Footnotes
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of the American Pain Society
