Heather M O'Leary1, Peter B Marschik2,3, Omar S Khwaja4, Eugenia Ho5, Katherine V Barnes1, Tessa W Clarkson6, Natalie M Bruck1, Walter E Kaufmann1. 1. a Department of Neurology , Boston Children's Hospital and Harvard Medical School , Boston , MA , USA. 2. b Institute of Physiology, Graz Medical University , Graz , Austria. 3. c Department of Women's and Children's Health , Center for Neurodevelopmental Disorders (KIND), Karolinska Institute , Stockholm , Sweden. 4. d Roche Pharma Research and Early Development, Roche Innovation Center, F. Hoffmann-La Roche , Basel , Switzerland. 5. e Department of Neurology , Children's Hospital Los Angeles , Los Angeles , CA , USA , and. 6. f Division of Developmental Medicine , Boston Children's Hospital and Harvard Medical School , Boston , MA , USA.
Abstract
OBJECTIVE: To quantify pain response in girls affected by Rett syndrome (RTT) using electrodermal activity (EDA), a measure of skin conductance, reflecting sympathetic activity known to be modulated by physical and environmental stress. METHODS: EDA increase, heart rate (HR) increase and Face Legs Activity Cry Consolability (FLACC) values calculated during venipuncture (invasive) and vital signs collection (non-invasive) events were compared with values calculated during a prior baseline and a RTT clinical severity score (CSS). RESULTS: EDA and HR increase were significantly higher than baseline during venipuncture only and not significantly correlated with FLACC or CSS. EDA increase was the most sensitive measure of pain response. CONCLUSIONS: These preliminary findings revealed that motor impairment might bias non-verbal pain scales, underscore the importance of using autonomic measures when assessing pain and warrant further investigation into the utility of using EDA to objectively quantify RTT pain response to inform future RTT pain management.
OBJECTIVE: To quantify pain response in girls affected by Rett syndrome (RTT) using electrodermal activity (EDA), a measure of skin conductance, reflecting sympathetic activity known to be modulated by physical and environmental stress. METHODS:EDA increase, heart rate (HR) increase and Face Legs Activity Cry Consolability (FLACC) values calculated during venipuncture (invasive) and vital signs collection (non-invasive) events were compared with values calculated during a prior baseline and a RTT clinical severity score (CSS). RESULTS:EDA and HR increase were significantly higher than baseline during venipuncture only and not significantly correlated with FLACC or CSS. EDA increase was the most sensitive measure of pain response. CONCLUSIONS: These preliminary findings revealed that motor impairment might bias non-verbal pain scales, underscore the importance of using autonomic measures when assessing pain and warrant further investigation into the utility of using EDA to objectively quantify RTT pain response to inform future RTT pain management.
Authors: Alyssa M Merbler; Breanne J Byiers; John Hoch; Adele C Dimian; Chantel C Barney; Timothy J Feyma; Arthur A Beisang; Alessandro Bartolomucci; Frank J Symons Journal: J Child Neurol Date: 2019-09-25 Impact factor: 1.987
Authors: Aritra Bhattacherjee; Ying Mu; Michelle K Winter; Jennifer R Knapp; Linda S Eggimann; Sumedha S Gunewardena; Kazuto Kobayashi; Shigeki Kato; Dora Krizsan-Agbas; Peter G Smith Journal: Proc Natl Acad Sci U S A Date: 2017-07-31 Impact factor: 11.205