Higher Pain Threshold Research Articles

Novel truncating PPM1D mutation in a patient with intellectual disability

Truncating mutations in the last and penultimate exons of the PPM1D gene were recently described as a cause for mild to severe intellectual disability in fourteen patients. Feeding difficulties, periods of fever and vomiting as well as a high pain threshold were described as additional characteristic features and the disorder was subsequently termed “intellectual developmental disorder with gastrointestinal difficulties and high pain threshold (IDDGIP)” in the OMIM database (MIM # 617450). Here we report on an additional patient carrying a novel de novo truncating mutation NM_003620.3: c.1535del, p.(Asn512Ilefs*2) in the last exon of PPM1D. While the patient showed features overlapping with the reported phenotype, such as a short stature and small hands and feet, he also presented with additional features like cleft lip and palate and an aberrant right subclavian artery. Notably, the patient did not have any gastrointestinal difficulties or periods of fever, indicating variability of the phenotype of patients with PPM1D mutations.

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 objective of this prospective long-term follow-up study was to investigate whether somatosensory function is altered among young adults born preterm with very low birth weight (VLBW; ≤1,500 g) or small for gestational age (SGA; <10th percentile) at term. In a blinded quantitative sensory testing protocol, we determined thermal detection, thermal pain, and pressure pain thresholds and the response to prolonged supra-threshold heat among 51 VLBW, 66 term SGA, and 86 term-born controls (birth weight ≥10th percentile) at 28 years. Self-reported chronic pain was also investigated. Except for increased sensitivity to cool in the term SGA group versus controls, we found no significant group differences regarding thermal or pain thresholds. Overall, male participants had higher pain thresholds, and no significant interactions of group and sex were observed (P > .14). Within the VLBW group, neonatal mechanical ventilation was associated with reduced sensitivity to cool, and length of mechanical ventilation correlated with lower pressure pain thresholds. The response to prolonged supra-threshold heat was similar between the groups, and the prevalence of self-reported chronic pain was not reliably different. In conclusion, low birth weight young adults were as sensitive to thermal and pain stimuli as term-born, normal birth weight controls, with the same sex differences. PerspectiveTo our knowledge, this is the first report on thermal and pain sensitivity among young adults born preterm with VLBW or SGA at term. The negative results from a comprehensive quantitative sensory testing protocol oppose previous findings of altered sensory perception among children and adolescents born preterm.

Heart rate variability is associated with thermal heat pain threshold in males, but not females

Previous research has suggested that heart rate variability (HRV; the variability in the interval between successive heartbeats) can predict the perception of experimentally-induced pain (i.e., pain sensitivity). However, little research has sought to investigate sex-specific associations between HRV and pain sensitivity. This is an important consideration, given that sex differences in resting HRV have been observed, and there has been extensive debate about sex differences in sensitivity to experimentally-induced pain. We examined whether the association between resting HRV and sensitivity to experimentally-induced pain differed in men and women. Fifty-one pain free individuals (26 women, mean age = 21.9 years) participated. Resting electrocardiography (ECG) was collected during a paced breathing task (15 cycles per minute), and measures of HRV were extracted via Fast Fourier Transformation. Thermal heat pain threshold (i.e., the point at which the sensation was first perceived as painful, rather than warm) was measured with a Medoc Pathway Pain and Sensory Evaluation System. There were no sex differences in resting HRV or thermal heat pain threshold, nor did sex moderate the relationship between HRV and thermal heat pain threshold. However, there were significant positive relationships between thermal heat pain threshold and LF-HRV (r = 0.47), and HF-HRV (r = 0.43) in men, but not in women. The results suggest that higher pain threshold appears to be related to greater engagement of the inhibitory parasympathetic nervous system in men only, and that other biopsychosocial mechanisms may contribute to experimental pain experience in women. Future research is needed to study these mechanisms further, accounting for other factors known to influence nociceptive and cardiovascular regulatory processes (e.g., ethnicity, hormones).

Is Resolution of Chronic Pain Associated With Changes in Blood Pressure-related Hypoalgesia?

In healthy individuals, elevated resting blood pressure (BP) is associated with reduced pain responsiveness and lower temporal summation. Prior work indicates that this BP-related hypoalgesia is reduced in individuals with chronic pain. This study evaluated whether resolution of chronic pain was associated with greater BP-related hypoalgesia compared to nonresolution. From a prospective sample of adolescents and young adults diagnosed with chronic functional abdominal pain an average of 9 years earlier, 99 individuals in whom the condition had resolved and 51 individuals with ongoing abdominal pain were studied. Resting systolic BP was assessed, followed by evaluation of thermal pain threshold and tolerance, and assessment of temporal summation to thermal pain stimuli. Higher resting systolic BP was significantly associated with higher pain threshold and tolerance, and lower temporal summation only in the group with resolved functional abdominal pain (p < .05). Hierarchical regressions revealed that interactions between BP and resolution of chronic pain were significant only for pain tolerance (p < .05). Analyses by sex indicated that interactions between BP and resolution status were significant for the temporal summation outcome in males but not in females. Results suggest that BP-related hypoalgesic mechanisms may be more effective in individuals in whom chronic pain has resolved compared to those with ongoing chronic pain. Findings hint at sex differences in the extent to which resolution of chronic pain is associated with BP-related hypoalgesia. Whether greater BP-related hypoalgesia is a consequence of, or alternatively a contributor to, resolution of chronic pain warrants further investigation.

(113) - Loss of the sodium proton exchanger NHE6 impairs nociceptive transmission in christianson syndrome

Christianson Syndrome (CS) is a recently characterized X-linked neurodevelopmental disorder caused by loss-of-function mutations in the gene Slc9a6, encoding the Na+/H+ Exchanger 6 (NHE6). The disease is associated with intellectual disability, mutism, loss of motor function and susceptibility to seizures. Interestingly, CS patients exhibit unusually high pain thresholds; the underlying causes of which have not been examined. This study aims at understanding how loss-of-function of NHE6 affects pain transmission. To this end, we examined the expression of NHE6 in peripheral and central neurons implicated in pain transmission. Additionally, we examined the mechanical and thermal nociceptive behavior of an NHE6 knockout mouse as a model of CS. Our immunohistochemical experiments demonstrate that NHE6 is highly expressed in nociceptive, small-diameter dorsal root ganglia (DRG) neurons. Specifically, the exchanger mostly co-localized with CGRP-expressing and IB4-binding neurons and less so with large-diameter proprioceptive parvalbumin neurons. Moreover, mice lacking NHE6 display decreased responses to noxious mechanical and thermal stimuli in nociceptive behavior tests. Interestingly, immunohistochemical characterization of DRG tissue from aged NHE6 null mice indicates a decrease in some neuronal subsets suggesting cell death. Our preliminary results suggest a potential role for NHE6 in the proper functioning of nociceptive neurons in DRGs. The contribution of a peripheral defect to the impaired nociception will be further examined by an electrophysiological characterization of DRG neurons acutely dissociated from NHE6 knockout mice and wildtype littermates. These findings will increase our understanding of pain transmission in health and disease.

Neuroticism and pain catastrophizing aggravate response to pain in healthy adults: an experimental study.

BackgroundThe aim of this study was to investigate the association between neuroticism, pain catastrophizing, and experimentally induced pain threshold and pain tolerance in a healthy adult sample from two regions of the country of Croatia: the island of Korcula and city of Split.MethodsA total of 1,322 participants were enrolled from the Island of Korcula (n = 824) and the city of Split (n = 498). Participants completed a self-reported personality measure Eysenck Personality Questionnaire (EPQ) and pain catastrophizing questionnaire Pain Catastrophizing Scale (PCS), followed by a mechanical pain pressure threshold and tolerance test. We have explored the mediating role of catastrophizing in the relationship between neuroticism and pain intensity.ResultsThe results showed that pain catastrophizing partially mediated the relationship between neuroticism and pain intensity, suggesting the importance of pain catastrophizing in increasing vulnerability to pain. The results also indicated gender-related differences, marked by the higher pain threshold and tolerance in men.ConclusionsThis study adds to the understanding of the complex interplay between personality and pain, by providing a better understanding of such mechanisms in healthy adults.

Fecal Microbiota Transplantation Is Effective in Relieving Visceral Hypersensitivity in a Postinfectious Model.

Aim To investigate the effect of fecal microbiota transplantation on visceral hypersensitivity compared with Bifidobacterium longum. Methods Mice visceral hypersensitivity was induced by Trichinella spiralis. After 8 weeks, they were divided into three groups (controls, Bifidobacterium longum, and fecal microbiota transplantation) and were daily treated by gavage with 0.2 ml PBS, Bifidobacterium longum HB55020, or fecal microbiota for 7 days. Visceral hypersensitivity was tested with abdominal withdrawal reflex. Permeability of colon epithelium was assessed with Ussing chamber. Results After administration of Bifidobacterium longum, compared with mice in postinfectious group, mice had higher pain threshold (p < 0.05). After administration of fecal microbiota, compared with mice in postinfectious group, mice had higher pain threshold (p < 0.05). Fecal microbiota transplantation was as effective as Bifidobacterium in relieving visceral hypersensitivity. Administration of Bifidobacterium longum or fecal microbiota transplantation improved colon epithelium permeability. Expression of occluding-1 was increased. Conclusion Manipulation of microbiota is effective in relieving visceral hypersensitivity. Fecal microbiota transplantation is as effective as Bifidobacterium longum administration.

Life After Giving Life.

Life After Giving Life Jeff Moyer I donated my right kidney to save a friend's daughter's life in June 2010. I dreaded the pain but knew that it would pass. My age at 61 and my gender proffered a hard recovery period; one renowned transplant center would have rejected me as a donor. Internet research disclosed nothing about chronic pain as a potential after-effect of the donation. My transplant center knew for three months that, due to vascular anomalies, I would require a difficult right side nephrectomy. I had inquired repeatedly about what they learned and, although it would not have changed my decision, I was not informed of this until three days before the donation. The surgeon peevishly told me that the operation would be far more difficult—for the surgeon. In the hospital, following the synthetic Morphine pain pump, I was prescribed Vicodin to take once a day. I have a high pain threshold, but I would find myself watching the clock until my self-assigned time at which I would take my medication and only one of two allotted tablets at that. I am a writer and I convinced my editor at NPR to permit me to do bookend commentaries pre and post donation. The first piece aired the Monday of surgery week. I spoke of my trepidation concerning the pain, but how my resolve stiffened once I had my first conversation with my fragile recipient and realized that I would have to marshal needed courage for both of us. After a month I recorded the second commentary, and I sounded road-worn and in pain. The Transplant Center refused to continue to prescribe me Vicodin after twelve weeks. Hand assisted laparoscopic is the standard surgical method for all transplant nephrectomies. With typical left-side nephrectomy, the surgeon reaches under the stomach muscles and bags the left kidney. In my case, four and half inches of stomach muscles were severed and the spleen, stomach, colon and liver were cut away from their supportive myofascial web and matter-of-factly moved to get to the right kidney. Once the kidney was removed, the resulting stitching of these organs to stabilize their position has caused adhesions and attendant pain. A recent surgical graduate of the transplant center's program described the surgery to me in shocking, mind-numbing detail. The surgeon said he had never known of a patient in pain after twelve weeks. His rebuke questioned my veracity. Although I was an "altruistic donor," my motives were impugned. I went from being seen as a noble and honorable man to a complainer and thrill seeker. My general practitioner skeptically and begrudgingly continued the Vicodin prescription—requiring visits every 90 days. Very fortunately, I became friends with another living kidney donor, a nurse and knowledgeable advocate, who taught me a lot about that woebe-gone and ignored world. Most importantly, she was affirming and wove me into the world of other donors. At a year post-surgery, I had a conversation with the head of the transplant center, during which he told me that there was no such thing as pain. He said pain was "an internal psychological perception and labeling of a neurological stimulus." I disagreed. I considered a third commentary on living with chronic pain, but in consultation with my "Morning Edition" editor, we widened the lens. She approached their Science Desk about doing a long Health Section piece on the plight of living kidney donors. The concept was accepted. A [End Page 211] reporter in my home town was assigned the story. I put a small group of highly knowledgeable kidney donors together, one of whom was also a wounded donor, who met at my house for the reporter's interviews. Other national experts were spoken with and the bleak plight of living kidney donors was laid bare in a nine-minute piece on "Morning Edition". There was (is?) no longitudinal research in the United States which followed us, although European studies disclose that over one third of living kidney donors live with chronic pain. I had been a volunteer musician at a hospice center prior to my surgery and upon my return...

Pain sensitivity and cardiovascular reactivity to the experimental induced cold pressor pain during different phases of menstrual cycle in young Indian females

Background: Many previous research studies have shown a higher prevalence of chronic pain conditions as well as more pain sensitivity or lesser pain thresholds (PTh) among women as compared to men. It might be related to the effect of female reproductive hormones, as these hormones produce its effect on various aspects of physiological systems. Aims and Objectives: The aim of this study is to find the differences in the pain responses as well as cardiovascular reactivity during cold pressor test in different phases of menstrual cycle. Materials and Methods: Following physical parameters were measured in 75 apparently healthy young Indian females during the three phases of menstrual cycle and utilized for data analysis: Response to cold-induced experimental pain in the form of PTh, pain tolerance (PTo), pain rating on visual analogous scale, pulse reactivity (PRe), systolic blood pressure reactivity (SBPRe), and diastolic BPRe (DBPRe). Results: Mean PRe was significantly higher during luteal phase as compared to menstrual as well as follicular phase. Mean SBPRe and mean DBPRe were found to be significant higher during luteal phase as compared to the menstrual and follicular phase. Mean PTh and mean PTo were significantly higher during follicular phase as compared to menstrual as well as luteal phase. Conclusion: This is concluded from above findings that the pain responses vary across the menstrual cycle as shown by higher PTh and tolerance during follicular phase of menstrual cycle. The cardiovascular reactivity to cold pressor pain also varies. The hormonal fluctuation and the differences in the physiological responses, mainly autonomic nervous system reactivity due to these fluctuations, would be the underlying mechanism for these findings.

Recomendaciones para la atención a los adultos con síndrome de Down. Revisión de la literatura

Over the years, the life expectancy for individuals with Down syndrome (DS) has increased significantly. This fact involves a higher risk for developing numerous medical conditions associated with the aging of adults with DS. A high level of awareness is required by the professional, due to the lack of clinical expressiveness and their higher pain threshold, often makes the diagnosis difficult. Health care professionals must be aware of the specific recommendations for the appropriate care of the adult population with DS. The aim of this article is to describe the most frequent comorbidities in adults with DS adults, to summarise the specific preventive recommendations after comparing the main guidelines published, and to evaluate them according to their specific needs.

Скринінгова оцінка адаптаційного потенціалу при стресі у хірургічних стоматологічних хворих

The degree of stress expressiveness in surgical stomatological patients depends on the adaptation reserve of their organisms. Adaptation to stress in every person is individual. It was found that the most sensitive indicator (marker) of the level of reactivity of an organism in stress is a nociceptive reaction that has the functional stability of neurophysical and neurochemical mechanisms of formation.The aim of the study – to make a screening of the adaptational potential in stomatological patients with different individually-psychological peculiarities under condition of pain stress.Materials and Methods. The objects of clinical observation were 95 surgical stomatological patients. Their individual psychological characteristics were assessed by special questionnaire (S. Novikova, 2006) allowing defi ning the preference of either sthenic or asthenic manifestations in both emotions and behavior of the patients. Neurofunctional research was done by electromyography M-TEST. Stress in patients was induced by electrical stimulation of mental nerve till the appearance of pain reaction that was measured by method of exteroceptive suppression of arbitrary activity of masticatory muscles. It was determined: the threshold of pain, its range and tolerance to pain. According to the results of algometry all the patients were classifi ed into 4 pain perception types. During the operation of the pain factor, a change in the tone of the peripheral vessels was studied by using the index of perfusion (PI), which is according to the literature data recommended for dynamic monitoring of the infl uence of the sympathetic nervous system on hemodynamics. Adaptational vegetative cardiovascular reactions to stress were assessed by the Baievskyi index of functional changes (IFC)=0.011 pulse rate + 0.014 systolic blood pressure + 0.008 diastolic blood pressure +0.014 age + 0.009 body weight – 0.009 growth – 0.27.Results and Discussion. 26 patients with asthenic psychotype in which the threshold of pain and pain tolerance were not high belong to the pain perception type 1. In these patients adaptation of the autonomic nervous system to stress were unsatisfactory (functional changes index (IFC)=(3.35±0.49) points). In patients with the pain perception type 2 threshold of pain sensitivity was similar to those of the type 1, but the range proved to be much longer because of the high threshold of pain tolerance. In this group we noticed functional manifestations of stress-induced analgesia accompanied by exertion of adaptation mechanisms – IFC=(2.86±0.14) points. Such pain perception type was diagnosed in 35 patients with a great prevalence of sthenic features. High pain thresholds were diagnosed in patients with pain perception type 3 and 4, however, owing to the insuffi cient activity of endogenous antinociceptive system in the group 3 the range of pain sensitivity was short. Such pain perception type was found in 15 patients. They manifested both sthenic and asthenic features during psychological testing, Baievskyi stress index (IFC – (3.48±1.12) points) showed unsatisfactory adaptation of cardiovascularsystem to stress in these patients. High indicators of antinociceptive system activity were found in patients with pain perception type 4 including personalities having considerable sthenic characteristics. They showed to have tolerable adaptation of cardiovascular system to stress (IFC – (2.35±0.89) points).Conclusions. The results of clinical observations suggest that the adaptive capacity of patients with stressful (pain) effects depends on their individual psychological characteristics, the level of activation of antistress (antinociceptive) mechanisms, the state of the autonomic nervous system, which are components of the general non-specifi c reactivity of the organism. Patients with increased pain sensitivity are characterized by low resistance to stress, lability of the autonomic nervous system, low level of adaptive capacity. High resistance to stress is characteristic for subjects with stenotic psycho-emotional type, which have high thresholds for pain sensitivity. Adaptation capabilities of the body of patients with stress should be taken into account when they are medically prepared for surgical intervention.

Perceptions of Pain, Injury, and Transition-Retirement: The Experiences of Professional Dancers.

Dancers are often referred to as "athletes of the arts," and like other athletes they undergo years of hard physical training in pursuit of excellence. Previous research has indicated that dancers develop high pain thresholds and push past their pain barriers. This has potential implications for their health and wellbeing in both their professional careers and life after dance. Therefore, the purpose of this pilot study was to explore the perceptions and experiences of injury, pain, and retirement among professional dancers. Twenty professional dancers, 10 from the United Kingdom and Canada, hereafter referred to as "international," and 10 from Australia participated in a semi-structured interview reflecting on their experiences of the aforementioned issues. The following themes were identified: 1. the injured dancer: the reality; 2. dancers' perceptions and experiences of pain; 3. the transition leading to retirement; and 4. life after dance: attributes facilitating career change. Results from both Australian and international dancers revealed that they withstand, manage, and dance through persistent levels of pain and injury. All participants reported that they were highly motivated and dedicated to their dance careers; however, the majority of Australian dancers were not adequately prepared for, or aware of, the challenges of transition into their post-professional dance lives when compared to the international dancers. Dancer transition organizations currently operate in America, the Netherlands, Canada, and the United Kingdom and serve as valuable models that could be replicated in Australia. The current study recommends increased awareness of pain management and injury prevention strategies for dancers and further supports the rationale for development and implementation of transition models for dancers in Australia and elsewhere.

Biopsychosocial Rehabilitation Programme for Patients with Chronic Back Pain. Pilot Study.

In the search for effective and comprehensive therapies of back pain, an increasing emphasis in being placed on the biopsychosocial model and multidimensional support programmes for patients as well the use of modern technologies in this area of medicine. This study aimed to assess a programme of customised ad hoc physiotherapeutic consultations for patients with back pain who had been on the waiting list for rehabilitation treatment for a long time. The study group comprised 68 patients of the Rehabilitation Centre Non-Public Health Care Institution who had been waiting for rehabilitation treatment for at least three months. The patients, diagnosed with chronic back pain and aged 40-80 years, were randomly assigned into two groups. The experimental group took part in a programme of three consultations, provided on average once a month. The patients from both groups were assessed after the three-month programme, immediately before the commencement of the prescribed rehabilitation treatment. We evaluated the pain threshold at trigger points of selected muscles using the algometric method (kg/cm 2 ), subjective assessment of pain (VAS), functional limitations (Rolland Morris Disability Questionnaire) and quality of life (36-Item Short Form Health Survey, SF-36). The statistical analysis of the results used non-parametric methods: significance of differences between the groups was evaluated with the Mann-Whitney U test and correlations between the variables were assessed separately for each group using Spearman's rank order correlation. The significance threshold was accepted at α=0.05. The algometric evaluation of all the muscles revealed significantly lower sensitivity to pain, demonstrated by a higher pain threshold (p<0.0001), in the experimental group. Moreover, this group also included a much smaller percentage of patients with a high level of functional limitations according to the Rolland Morris Disability Questionnaire. The quality of life evaluation revealed that the control group scored poorer in the mental domain (p=0.02). The ad hoc intervention programme for patients referred for rehabilitation due to chronic back pain showed demonstrable beneficial effects with regard to their psychophysical health. Similar programmes should be more readily offered to patients at health care centres and implemented into clinical practice.

Metabolic Parameters and Orexigenic/Anorexigenic Factors of Obesity in Prader-Willi Syndrome

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that arises from lack of expression of paternally inherited imprinted genes on chromosome 15 [1]. PWS is the most frequent cause of syndromic obesity occurring in 1 out of 10000–30 000 live births [2]. It is a neurodevelopmental disorder, characterized by neonatal hypotonia and failure to thrive, followed by a rapid weight gain between the ages of 1 and 6 years, leading most PWS subjects to develop morbid obesity and therefore premature mortality from its complications. The PWS phenotype includes multiple characteristics, most of which are central of origin (temperature dysregulation, high pain threshold, behavioral abnormalities, hypothalamic hypogonadism, growth hormone deficiency, central hypothyroidism, central adrenal insufficiency). Obesity, mostly due to an insatiable appetite, represents one of the most serious symptoms of PWS, leading to develop premature mortality from its complications. Therefore, we tried to investigate more deeply distinctive features of obesity and appetite regulation in PWS patients.

The relation of preoperative stress and anxiety on patients' satisfaction after implant placement.

Background:There are some factors which can affect preoperative patient anxiety such as the necessity of procedure, postoperative pain, and patient's conception of his body image. The aim of this study was to assess the relation of patients' preoperative anxiety and postoperative patients' satisfaction in dental implant surgery.Materials and Methods:Dental implants were placed in 40 patients (19 male and 21 female) who were referred to Dental Implant Surgery Department in Imam Reza clinic, during March–December of 2014 in Shiraz. The procedures were performed with or without bone regeneration. Preoperative anxiety was evaluated using Corah Dental Anxiety Scale, and postoperative satisfaction was determined on the basis of pain intensity, bleeding tendency, inability to eating, and overall satisfaction by filling a questionnaire in the 2nd or 3rd week after surgery. Data were collected and analyzed using Mann-Whitney test.Results:Preoperative anxiety was detected as high in 10%, mild in 85%, and moderate in 5% of patients. Anxiety and depression score did not differ in both genders. There was no statistical difference between neither level of anxiety nor depression in both high and low educated patients. Postoperative bleeding, difficulty in eating, and overall satisfaction was nearly the same in both genders. Statistical analysis demonstrated a lower pain level and higher pain threshold in men than women (P = 0.007). Patients' age was not related to anxiety, depression, amount of bleeding, pain, and difficulty in eating. Overall dental care satisfaction was similar in both men and women.Conclusion:The results of the study indicated that while anxiety does play a role in the perception of pain by patients undergoing implant surgery, overall patient satisfaction and post surgical outcomes did not significantly differ.

Effects of High Power Pain Threshold Static Ultrasound (HPPTSU) on Subjects with SI Joint Pathology

Effects of High Power Pain Threshold Static Ultrasound (HPPTSU) on Subjects with SI Joint Pathology

Influence of Sexual Hormones on Neural Orofacial Perception.

To investigate the trigeminal somatosensory (thermal, pain, tactile, vibratory, and electric), gustative (salty, bitter, sweet, sour), and olfactory thresholds in healthy women during the menstrual cycle and investigate any association with estradiol and progesterone levels in saliva. We examined/tested 39 women between age 19 and 47 years and with regular menstrual cycles and no comorbidities. All women were informed about the purposes of the study, and only those who signed the informed consent were included. The tests were performed at three stages within the cycle: menstrual phase, follicular phase, and luteal phase. The procedure consisted of saliva collection at the beginning of each session to measure hormone levels, salivary flow, somatosensory evaluation with quantitative sensory testing applied to the right trigeminal maxillary branch and right forearm, gustative (sweet [glucose], salt [sodium chloride], sour [citric acid], and bitter [urea]) and olfactory (isopropanol at different concentrations) thresholds. During the menstrual cycle, thresholds for sweet, salty, sour, cold, vibration, and deep pain decreased, but warmth, electrical, and superficial pain thresholds increased. The bitter threshold was high, and the olfactory threshold was low in the follicular phase. Low estrogen levels were correlated to high deep pain thresholds in the forearm ( P = 0.008) and face ( P = 0.041), high tactile thresholds ( P = 0.001), and high superficial pain ( P = 0.006) thresholds in the face. High levels of progesterone were associated with a high deep pain threshold in the face and a high salty threshold ( P < 0.001). Estrogen and progesterone seem to be involved in sensory neuromodulation in women during the menstrual cycle.

New insights into genotype-phenotype correlation in individuals with different level of general non-specific reactivity of an organism.

The objective of the study was to investigate the genetic basis of general non-specific reactivity of an organism. Systematic search in PubMedCentral, PDB, KEGG and SNP databases identified a set of genes and their polymorphisms that can determine pain sensitivity and therefore the level of general non-specific reactivity of the human organism. Six SNPs were selected for genotyping kit design; 230 healthy volunteers were enrolled in the study. It was revealed that very high pain threshold was associated with allele A in rs1851048 and allele C in rs6777055. High level of general non-specific reactivity of an organism was associated with allele G in rs2562456 (OR=1.804, CI=1.139-2.857, p=0.011) and allele C in rs6923492 (OR=1.582, CI=1.071-2.335, p=0.021). Low level of general non-specific reactivity of an organism was associated with allele T in rs6923492 (OR=0.351, CI=0.154-0.799, p=0.010). A set of genes and single-nucleotide polymorphisms associated with the pain sensitivity and indirectly with the level of general non-specific reactivity of human organism were determined. The identified correlations reveal some molecular mechanisms of general non-specific reactivity of an organism variability and can guide further research in this area.

New insights into genotype–phenotype correlation in individuals with different level of general non-specific reactivity of an organism

Summary The objective of the study was to investigate the genetic basis of general non-specific reactivity of an organism. Systematic search in PubMedCentral, PDB, KEGG and SNP databases identified a set of genes and their polymorphisms that can determine pain sensitivity and therefore the level of general non-specific reactivity of the human organism. Six SNPs were selected for genotyping kit design; 230 healthy volunteers were enrolled in the study. It was revealed that very high pain threshold was associated with allele A in rs1851048 and allele C in rs6777055. High level of general non-specific reactivity of an organism was associated with allele G in rs2562456 (OR=1.804, CI=1.139-2.857, p=0.011) and allele C in rs6923492 (OR=1.582, CI=1.071-2.335, p=0.021). Low level of general non-specific reactivity of an organism was associated with allele T in rs6923492 (OR=0.351, CI=0.154-0.799, p=0.010). A set of genes and single-nucleotide polymorphisms associated with the pain sensitivity and indirectly with the level of general non-specific reactivity of human organism were determined. The identified correlations reveal some molecular mechanisms of general non-specific reactivity of an organism variability and can guide further research in this area.

Étude des facteurs de risque des comportements agressifs dans les troubles du spectre autistique

BackgroundWhen coping with auto- and hetero-aggressive behavior in children with autism spectrum disorders, the child psychiatrist has a double role: treating these behaviors as well as identifying at risk persons and situations. ObjectivesIn this perspective, our work aimed to study the risk factors of auto- and hetero-agressivity in behavioral self-hetero-aggressive. MethodsWe conducted a transversal study of 50 children with autism spectrum disorder (DSM-5 criteria). The diagnosis was confirmed by the Autism Diagnostic Interview-Revised (ADI-R). The severity of autism was determined by the Childhood Autism Rating Scale (CARS). Aggressive behaviors were assessed by the Behavior Problems Inventory (BPI-01) translated and validated in Arabic. The psycho-educational profile revised (PEP-R) evaluated, through the seven domains of development, the developmental age of each child. A predetermined plug collected information on the epidemiological and clinical characteristics. To determine the risk factors associated with aggressive behaviors, we conducted a univariate followed by a multivariate analysis. ResultsOur sample consisted of 50 children with ASD in accordance to DSM-5 criteria. The sex ratio was 4.5. Patients had an average age of 6 years (SD: 2) with extremes ranging from 2 to 12 years. Mean CARS score was 37.1 (SD: 7). Twenty percent of the children had a high functioning form of autism while the rest of the sample presented mild to moderate intellectual disability. The prevalence of auto-aggressive behavior was 46% and that of hetero-aggressiveness was of 60%. The univariate analysis found the following results. A statistically significant association was found between self-harm and the following factors: a higher age (P=0.007), a later age of diagnosis (P=0.006), digestive disorders (P=0.026; OR=4.28; 95% CI=1.1–16), high pain threshold (P=0.007; OR=5.8; 95% CI=1.5–21.8), intellectual disability (P=0.004), a lower score of perception at the PEP-R (P=0.045), and a higher score on the ADI-D (P=0.001). A statistically significant association was found between hetero-aggressive behavior and the following factors: a higher age (P=0.042) and the absence of the “no” opposition (P=0.017; OR=0. 1; 95% CI=0.1–0.9). The multivariate analysis isolated three independent factors for self-harm: a higher age (P=0.011; adjusted OR=1.05; 95% CI=1.01–1.09), digestive disorders (P=0.016; adjusted OR=17.5; 95% CI=1.7–1.80), intellectual disabilities (P=0.008; adjusted OR=0.9; 95% CI=0.8–0.9); and two independent factors for hetero-aggressiveness: a higher age (P=0.039; adjusted OR=1.03; 95% CI=1–1.06) and the absence of the “no” opposition (P=0.008; adjusted OR=0.1; 95% CI=0.02–0.56). ConclusionThese data invite us to consider the aggressiveness as a multifactorial behavior and to analyze aggressive behavior in light of the complex set of interactions between an individual and his environment.