Conditioned pain modulation identifies altered sensitivity in extremely preterm young adult males and females S.M. Walker, H. O'Reilly, J. Beckmann,

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Presentation transcript:

Conditioned pain modulation identifies altered sensitivity in extremely preterm young adult males and females S.M. Walker, H. O'Reilly, J. Beckmann, N. Marlow British Journal of Anaesthesia Volume 121, Issue 3, Pages 636-646 (September 2018) DOI: 10.1016/j.bja.2018.05.066 Copyright © 2018 The Author(s) Terms and Conditions

Fig 1 Flow chart of participant numbers and assessments. CPM, conditioned pain modulation; F, female; M, male. British Journal of Anaesthesia 2018 121, 636-646DOI: (10.1016/j.bja.2018.05.066) Copyright © 2018 The Author(s) Terms and Conditions

Fig 2 Effect of preterm birth, sex, and time on pressure pain threshold during conditioned pain modulation (CPM). (a) Change in mechanical pressure pain threshold over the right fibula head (PPT, raw data, kPa) in term control (TC) and extremely preterm (EP)-born young adults during (15 s) and after (50 and 90 s) a conditioning stimulus (0–30 s). Females unable to tolerate immersion until the parallel PPT measurement (<15 s) had no significant change in PPT with time. Additional groups with <15 s immersion were too small for analysis (five EP males, four TC females, and two TC males). Data points=mean [95% confidence interval (CI)]. (b) and (c) Change in log-normalised PPT (ln kPa) with time in (b) males and (c) females. For EP and TC participants tolerating at least 20 s conditioning, PPT is significantly increased above baseline at 15 and 50 s. In EP females with <15 s immersion, a minor increase in threshold is seen only at 15 s. Data points=mean (95% CI). ###P<0.001, #P<0.05, ***P<0.001, **P<0.01, *P<0.05, §P<0.05; two-way repeated measures analysis of variance with Bonferroni post hoc comparisons of within-group change compared with baseline. British Journal of Anaesthesia 2018 121, 636-646DOI: (10.1016/j.bja.2018.05.066) Copyright © 2018 The Author(s) Terms and Conditions

Fig 3 Degree of conditioned-pain-modulation effect after at least 20 s conditioning stimulus in extremely preterm (EP) and term-born control (TC) males and females. (a) The percentage change in pressure pain threshold (PPT) during the conditioning stimulus is not significantly different across groups based on EP status or sex. Individual data points, bars=mean [95% confidence interval (CI)]. (b) Raised PPT during the conditioning stimulus (15 s) is maintained at 50 and 90 s. Data points=mean (95% CI); ***P<0.001; **P<0.01 all groups increase vs baseline; #P<0.05 TC males, EP females, and EP males vs baseline; two-way repeated measures analysis of variance with Bonferroni post hoc comparisons. British Journal of Anaesthesia 2018 121, 636-646DOI: (10.1016/j.bja.2018.05.066) Copyright © 2018 The Author(s) Terms and Conditions