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Journal Article Scoping Review Ppublish 4 citations

PubMed: 37815822 DOI: 10.1093/pm/pnad133

Altered pain processing and sensitization in sickle cell disease: a scoping review of quantitative sensory testing findings.

Pain Med 25(2):144-156

Authors: Martha O Kenney, Mitchell R Knisely, Lakeya S McGill, Claudia Campbell

Affiliations

  • Division of Pediatric Anesthesiology, Department of Anesthesiology, Duke University, Durham, NC 27710, United States.
  • Duke University School of Nursing, Durham, NC 27710, United States.
  • Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States.
  • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States.

Abstract

OBJECTIVES

Over 50% of adults living with sickle cell disease (SCD) have chronic pain, but the underlying mechanisms of chronic pain in this population remain unclear. Quantitative sensory testing is an important measurement tool for understanding pain and sensory processing. This scoping review summarizes quantitative sensory testing methodologies used in sickle cell studies and the evidence for central sensitization in this population.

METHODS

We conducted a systematic search of PubMed, Embase, and CINAHL to identify studies using quantitative sensory testing in individuals living with sickle cell disease. Search strategies were based on variations of the terms "sickle cell disease," and "quantitative sensory testing." Eligible studies were observational or experimental studies in human participants living with SCD that reported findings and detailed methodology for at least 1 quantitative sensory testing modality.

RESULTS

Our search yielded a total of 274 records; 27 of which are included in this scoping review. Of the 27 studies, 17 were original studies (with combined total of 516 adult and 298 pediatric participants), and 10 were secondary or subgroup analyses of these prior studies. Significant variation existed in quantitative sensory testing methodologies across studies, including testing locations, type and intensity of stimuli, and interpretation of findings. Of the identified studies, 22% (2/9 studies) reported sensory abnormalities in mechanical sensitivity and thresholds, 22% (2/9 studies) reported abnormal pressure pain thresholds, 46% (6/13 studies) reported sensory abnormalities in thermal pain thresholds and tolerance (cold and warm), and 50% (2/4 studies) reported abnormalities in temporal summation.

CONCLUSION

Future studies should use standardized quantitative sensory testing protocols with consistent and operationalized definitions of sensitization to provide clear insight about pain processing and central sensitization in sickle cell disease.

MeSH

Anemia, Sickle Cell, Research Design, Pain Threshold, Cells, Central Nervous System Sensitization, Chronic Pain, Pain Management

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