Abstract

Self-reporting of pain can be difficult in populations with communication challenges or atypical sensory processing, such as children with autism spectrum disorder (ASD). Consequently, pain can go untreated. An objective method to identify discomfort would be valuable to individuals unable to express or recognize their own bodily distress. Near-infrared spectroscopy (NIRS) is a brain-imaging modality that is suited for this application. We evaluated the potential of detecting a cortical response to discomfort in the ASD population using NIRS. Using a continuous-wave spectrometer, prefrontal and parietal measures were collected from 15 males with ASD and 7 typically developing (TD) males 10-15 years of age. Participants were exposed to a noxious cold stimulus by immersing their hands in cold water and tepid water as a baseline task. Across all participants, the magnitude and timing of the cold and tepid water-induced brain responses were significantly different (p < 0.001). The effect of the task on the brain response depended on the study group (group x task: p < 0.001), with the ASD group exhibiting a blunted response to the cold stimulus. Findings suggest that NIRS may serve as a tool for objective pain assessment and atypical sensory processing.

Highlights

  • Recognizing pain or discomfort is an assessment typically made by oneself or a caregiver

  • We investigated the potential of using Near-infrared spectroscopy (NIRS) to detect a response to a noxious cold stimulus in the children with Autism Spectrum Disorder (ASD) using the cold pressor task (CPT)

  • Our results show that the difference in brain response evoked by the noxious and control stimuli was influenced by the number of task repetitions when considering a 60s task duration

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Summary

Introduction

Recognizing pain or discomfort is an assessment typically made by oneself or a caregiver. This assessment can be challenging for individuals with atypical sensory processing and/or have difficulty understanding or recognizing their distress. An example population that faces these challenges are children with Autism Spectrum Disorder (ASD). Pain management can be especially difficult for caregivers and clinicians of these individuals. Unaddressed pain can delay injury treatment, increase the risk of further injury or cause psychological distress leading to self-injurious or aggressive behavior [1]. An objective means of identifying and evaluating pain would be of value for individuals unable to recognize and/or express their bodily distress

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