Increased auditory startle reflex in children with functional abdominal pain.
OBJECTIVE
To test the hypothesis that children with abdominal pain-related functional gastrointestinal disorders have a general hypersensitivity for sensory stimuli.


METHODS
Auditory startle reflexes were assessed in 20 children classified according to Rome III classifications of abdominal pain-related functional gastrointestinal disorders (13 irritable bowel syndrome [IBS], 7 functional abdominal pain syndrome; mean age, 12.4 years; 15 girls) and 23 control subjects (14 girls; mean age, 12.3 years) using a case-control design. The activity of 6 left-sided muscles and the sympathetic skin response were obtained by an electromyogram. We presented sudden loud noises to the subjects through headphones.


RESULTS
Both the combined response of 6 muscles and the blink response proved to be significantly increased in patients with abdominal pain compared with control subjects. A significant increase of the sympathetic skin response was not found. Comorbid anxiety disorders (8 patients with abdominal pain) or Rome III subclassification did not significantly affect these results.


CONCLUSIONS
This study demonstrates an objective hyperresponsivity to nongastrointestinal stimuli. Children with abdominal pain-related functional gastrointestinal disorders may have a generalized hypersensitivity of the central nervous system.
Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.bakker@psy.umcn.nl
Mirte J
MJ
Bakker
Frits
F
Boer
Marc A
MA
Benninga
Johannes H T M
JH
Koelman
Marina A J
MA
Tijssen
D015746:Abdominal Pain / Q000453:epidemiology / Q000503:physiopathology*; D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology; D019540:Area Under Curve; D001767:Blinking; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D004576:Electromyography; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D013216:Reflex, Startle; D012044:Regression Analysis; D018709:Statistics, Nonparametric