Pain in children with dyskinetic and mixed dyskinetic/spastic cerebral palsy

AIM: To evaluate pain prevalence and characteristics in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) cerebral palsy (CP) motor types. METHOD: Seventy-five participants with a diagnosis of CP and confirmed dyskinetic or mixed (dyskinetic/spastic) motor type took part in a multisite cross-sectional study. The primary outcome was carer-reported pain prevalence (preceding 2wks) measured using the Health Utilities Index-3. Secondary outcomes were chronicity, intensity, body locations, quality of life, and activity impact. RESULTS: Mean participant age was 10 years 11 months (SD 4y 2mo, range 5-18y). There were 44 males and 31 females and 37 (49%) had predominant dyskinetic CP. Pain was prevalent in 85% and it was chronic in 77% of participants. Fifty-two per cent experienced moderate-to-high carer-reported pain intensity, which was significantly associated with predominant dyskinetic motor types (p=0.008). Pain occurred at multiple body locations (5 out of 21), with significantly increased numbers of locations at higher Gross Motor Function Classification System levels (p=0.02). Face, jaw, and temple pain was significantly associated with predominant dyskinetic motor types (p=0.005). Poorer carer proxy-reported quality of life was detected in those with chronic pain compared to those without (p=0.03); however, chronic pain did not affect quality of life for self-reporting participants. INTERPRETATION: Pain was highly prevalent in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types, highlighting a population in need of lifespan pain management. WHAT THIS PAPER ADDS: Chronic pain prevalence in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types is high. Pain occurs across multiple body locations in predominant dyskinetic and mixed (dyskinetic/spastic) motor types. Less recognized locations of pain include the face, jaw, and temple for predominant dyskinetic motor types

Ontogeny of corticotropin-releasing hormone binding in anterior pituitaries of fetal sheep

Copyright © 2003 SAGE PublicationsObjective: Previous studies have shown that anterior pituitary expression of corticotropin-releasing hormone type 1 receptor (GRH-R1) decreases during late gestation. This study sought to determine whether this reduction is from a decrease in the number of cells expressing CRH receptors of a decrease in the number of CRH receptors per cell. Methods: Fetuses were studied at 100 days' gestational age (100 dGA), 120 dGA, or 140 dGA. Dispersed anterior pituitary cells were incumbated with or without fluorescein-conjugated CRH (FL-CRH). FL-CRH binding was assessed by flow cytometry. Results: The number of CRH receptors per cell decreased at 120 dGA and 140 dGA. However, because of an increase in the percentage of cells expressing CRH receptors at 120 dGA, the total receptor index was similar at 100 dGA and 120 dGA. The receptor index tended to decrease at 140 dGA. Conclusion: FL-CRH binding was decreased at 140 dGA due to a decrease in the percentage of cells binding CRH and the number of CRH receptors per cell. This could contribute to the decrease in CRH-stimulated adrenocorticotropin release during late gestation in fetal sheep.Young S. F., Rose J. C. and Schwartz J