title: Thermal detection thresholds in 5-year-old preterm born children; IQ does matter.
abstract: BACKGROUND
  Experiencing pain at newborn age may have consequences on one's somatosensory perception later in life. Children's perception for cold and warm stimuli may be determined with the Thermal Sensory Analyzer (TSA) device by two different methods.
  
  
  OBJECTIVE
  This pilot study in 5-year-old children born preterm aimed at establishing whether the TSA method of limits, which is dependent of reaction time, and the method of levels, which is independent of reaction time, would yield different cold and warm detection thresholds. The second aim was to establish possible associations between intellectual ability and the detection thresholds obtained with either method.
  
  
  METHODS
  A convenience sample was drawn from the participants in an ongoing 5-year follow-up study of a randomized controlled trial on effects of morphine during mechanical ventilation.
  
  
  METHODS
  Thresholds were assessed using both methods and statistically compared. Possible associations between the child's intelligence quotient (IQ) and threshold levels were analyzed.
  
  
  RESULTS
  The method of levels yielded more sensitive thresholds than did the method of limits, i.e. mean (SD) cold detection thresholds: 30.3 (1.4) versus 28.4 (1.7) (Cohen'sd=1.2, P=0.001) and warm detection thresholds; 33.9 (1.9) versus 35.6 (2.1) (Cohen's d=0.8, P=0.04). IQ was statistically significantly associated only with the detection thresholds obtained with the method of limits (cold: r=0.64, warm: r=-0.52).
  
  
  CONCLUSIONS
  The TSA method of levels, is to be preferred over the method of limits in 5-year-old preterm born children, as it establishes more sensitive detection thresholds and is independent of IQ.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands. j.degraaf.1@erasmusmc.nl
authors.forename: Joke
authors.initials: J
authors.lastname: de Graaf
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Valkenburg
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
mesh_terms: D000377:Agnosia / Q000139:chemically induced / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000628:therapy; D007360:Intelligence / Q000187:drug effects / Q000502:physiology*; D007361:Intelligence Tests; D008297:Male; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use; D010865:Pilot Projects; D012121:Respiration, Artificial / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000628:therapy; D012684:Sensory Thresholds / Q000502:physiology; D013697:Thermosensing / Q000502:physiology*
chemical_list: D009020:Morphine