F. Aksu

Reference values for quantitative sensory testing in children and adolescents: developmental and gender differences of somatosensory perception.

&NA; The Quantitative Sensory Testing (QST) protocol of the German research network on neuropathic pain (DFNS) encompassing all somatosensory modalities assesses the functioning of different nerve fibers and of central pathways. The aim of our study was: (1) to explore, whether this QST protocol is feasible for children, (2) to detect distribution properties of QST data and the impact of body site, age and gender and (3) to establish reference values for QST in children and adolescents. The QST protocol of the DFNS with modification of instructions and pain rating was used in 176 children aged 6.12–16.12 years for six body sites. QST was feasible for children over 5 years of age. ANOVAs revealed developmental, gender and body site differences of somatosensory functions similar to adults. The face was more sensitive than the hand and/or foot. Younger children (6–8 years) were generally less sensitive to all thermal and mechanical detection stimuli but more sensitive to all pain stimuli than older (9–12 years) children, whereas there were little differences between older children and adolescents (13–17 years). Girls were more sensitive to thermal detection and pain stimuli, but not to mechanical detection and pain stimuli. Reference values differ from adults, but distribution properties (range, variance, and side differences) were similar and plausible for statistical factors. Our results demonstrate that the full QST protocol is feasible and valid for children over 5 years of age with their own reference values.

Childhood diabetic neuropathy: functional impairment and non‐invasive screening assessment

Aim  Sensory diabetic neuropathy, determined by nerve conduction studies, is common in children with Type 1 diabetes. Diabetic neuropathy diagnoses are rarely made in paediatric daily care because they are asymptomatic, vibration detection is mostly normal and nerve‐conduction testing is impractical. The present study aims to: (1) describe somatosensory dysfunction in children with diabetes, (2) test whether diabetes duration and HbA1c are related to somatosensory dysfunction and (3) identify the best screening test for large‐fibre dysfunction, as indicated by nerve conduction studies.

Developmental and sex differences in somatosensory perception—a systematic comparison of 7- versus 14-year-olds using quantitative sensory testing

Summary Quantitative sensory testing in 7‐ and 14‐year‐olds based on a priori sample size calculations revealed higher pain sensitivity in 7‐year‐olds, but no sex‐related differences and similar detection thresholds. ABSTRACT There are controversial discussions regarding developmental‐ and sex‐related differences in somatosensory perception, which were found, eg, when comparing younger children (6–8 years), older children (9–12 years), and adolescents (13–16 years) using quantitative sensory testing (QST). The aim of our current study was to systematically assess the impact of age and sex using the QST protocol of the German Research Network on Neuropathic Pain (DFNS). QST, including thermal and mechanical detection and pain thresholds, was assessed in 86 healthy 7‐year‐old children (42 girls and 44 boys) and 87 healthy 14‐year‐old adolescents (43 girls and 44 boys). The sample size was calculated a priori to detect medium‐sized effects as found in the previous studies with adequate power. Developmental and sex differences were tested using univariate analysis of variance. Children were more sensitive to most pain stimuli, except cold pain stimuli, compared with adolescents, but did not differ in mechanical and thermal detection thresholds except in regard to cold stimuli. Sex had an impact only on warm detection, with girls being more sensitive. There were no interactions between age and sex. In conclusion, developmental changes during the puberty appear to influence pain perception, whereas sex effects in childhood are negligible. At present, it is not clear what brings about the differences between adult men and women that are apparent in epidemiological studies. Our results contradict the hypothesis that differences in peripheral nerve‐fiber functioning underlie sex effects.

Development of Somatosensory Perception in Children: A Longitudinal QST-Study

Cross-sectional studies on somatosensory perception in children demonstrate lower pain thresholds for children compared with adolescents. The aim of the present longitudinal study was to replicate these age-related differences in a longitudinal design. Total 38 children and adolescents aged 6 to 16 years (two girls and two boys within each year) participated in this study. Quantitative sensory testing (QST) according to the protocol of the German research network on neuropathic pain (DFNS) was assessed twice with an interval of 15.8 ± 3.0 months. Bland-Altman analyses describe the short-term reliability of the measurements. Intraindividual sensory development was measured using paired t-test and quantified by effect sizes Cohens d between the two measurements. QST parameters showed good short-term reliability. Over a period of 1 year, children became less sensitive to painful stimuli, especially to cold pain, pressure pain, and mechanical pain. No systematic developmental changes were observed in response to the other somatosensory stimuli. QST is reliable over short retest intervals. In line with previous results from cross-sectional studies, we find a decrease in pain sensitivity with increasing age but no differences in nonnociceptive somatosensory processing over a period of 1 year in children between 6 and 16 years of age. Taken together, these results highlight the importance of a reference-based interpretation of the individual QST data.

[Reference values for quantitative sensory testing in children and adolescents : Developmental and gender differences in somatosensory perception].

DOI 10.1007/s00482-010-0943-x Online publiziert: 4. August 2010

Quantitative Sensorische Testung bei Kindern und Jugendlichen nach dem Protokoll des Deutschen Forschungsverbundes Neuropathischer Schmerz (DFNS)

DOI 10.1007/s00482-010-0943-x Online publiziert: 4. August 2010

Quantitative Sensorische Testung bei Kindern und Jugendlichen nach dem Protokoll des Deutschen Forschungsverbundes Neuropathischer Schmerz (DFNS)@@@Reference values for quantitative sensory testing in children and adolescents: Alters- und Geschlechtsunterschiede der Referenzwerte@@@Developmental and gender differences in somatosensory perception

DOI 10.1007/s00482-010-0943-x Online publiziert: 4. August 2010