TY - JOUR
T1 - Venipuncture activates the cerebral cortex in children with intellectual disability
AU - Bembich, Stefano
AU - Morabito, Giuliana
AU - Simeon, Valentina
AU - Strajn, Tamara
AU - Rutigliano, Rosaria
AU - Di Rocco, Paola
AU - Cont, Gabriele
AU - Risso, Francesco Maria
AU - Peri, Francesca
AU - Barbi, Egidio
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Objective: To evaluate the pattern of cortical activation during a painful procedure, such as a venipuncture, in children with intellectual disability and compare it with that of cognitively healthy children. Study design and setting: A cohort study was conducted and cortical activation was assessed by multichannel cerebral near-infrared spectroscopy to monitor variations in oxyhaemoglobin and deoxyhaemoglobin (Hbb) in children with and without intellectual disability during a venipuncture for blood sampling with topical anaesthesia. Pain and distress were assessed as well using different validated pain scales (visual analogue scale and Non-Communicating Children's Pain Checklist-Postoperative Version for children with intellectual disability), and compared between groups. Participants: 16 children with severe to profound intellectual disability and 20 cognitively healthy peers (age range: 4-17 years). Results: When Hbb was analysed, children with intellectual disability exhibited a bilateral activation of the somatosensory (p<0.006) and right motor cortex (p=0.0045), whereas cognitively healthy peers never showed a cortical activation. Children with intellectual disability also showed more pain than controls (p=0.001). Conclusions: When subjected to a painful procedure, only children with intellectual disability show an activation of the cerebral cortex, even if topical anaesthesia is applied, and express more pain than cognitively healthy peers. The role of other issues in painful procedures, such as anxiety, fear or physical restraint, deserves further investigation.
AB - Objective: To evaluate the pattern of cortical activation during a painful procedure, such as a venipuncture, in children with intellectual disability and compare it with that of cognitively healthy children. Study design and setting: A cohort study was conducted and cortical activation was assessed by multichannel cerebral near-infrared spectroscopy to monitor variations in oxyhaemoglobin and deoxyhaemoglobin (Hbb) in children with and without intellectual disability during a venipuncture for blood sampling with topical anaesthesia. Pain and distress were assessed as well using different validated pain scales (visual analogue scale and Non-Communicating Children's Pain Checklist-Postoperative Version for children with intellectual disability), and compared between groups. Participants: 16 children with severe to profound intellectual disability and 20 cognitively healthy peers (age range: 4-17 years). Results: When Hbb was analysed, children with intellectual disability exhibited a bilateral activation of the somatosensory (p<0.006) and right motor cortex (p=0.0045), whereas cognitively healthy peers never showed a cortical activation. Children with intellectual disability also showed more pain than controls (p=0.001). Conclusions: When subjected to a painful procedure, only children with intellectual disability show an activation of the cerebral cortex, even if topical anaesthesia is applied, and express more pain than cognitively healthy peers. The role of other issues in painful procedures, such as anxiety, fear or physical restraint, deserves further investigation.
KW - neurodisability
KW - pain
KW - procedures
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U2 - 10.1136/archdischild-2019-318695
DO - 10.1136/archdischild-2019-318695
M3 - Article
C2 - 32769088
AN - SCOPUS:85089746693
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
SN - 0003-9888
ER -