title: Can biomarkers differentiate pain and no pain subgroups of nonverbal children with cerebral palsy? A preliminary investigation based on noninvasive saliva sampling.
abstract: OBJECTIVE
  Assessing and treating pain in nonverbal children with developmental disabilities are a clinical challenge. Current assessment approaches rely on clinical impression and behavioral rating scales completed by proxy report. Given the growing health relevance of the salivary metabolome, we undertook a translational-oriented feasibility study using proton nuclear magnetic resonance (NMR) spectroscopy and neuropeptide/cytokine/hormone detection to compare a set of salivary biomarkers relevant to nociception.
  
  
  METHODS
  Within-group observational design.
  
  
  METHODS
  Tertiary pediatric rehabilitation hospital.
  
  
  METHODS
  Ten nonverbal pediatric patients with cerebral palsy with and without pain.
  
  
  METHODS
  Unstimulated (passively collected) saliva was collected using oral swabs followed by perchloric acid extraction and analyzed on a Bruker Avance 700 MHz NMR spectrometer. We also measured salivary levels of several cytokines, chemokines, hormones, and neuropeptides.
  
  
  RESULTS
  Partial least squares discriminant analysis showed separation of those children with/without pain for a number of different biomarkers. The majority of the salivary metabolite, neuropeptide, cytokine, and hormone levels were higher in children with pain vs no pain.
  
  
  CONCLUSIONS
  The ease of collection and noninvasive manner in which the samples were collected and analyzed support the possibility of the regular predictive use of this novel biomarker-monitoring method in clinical practice.
authors.affiliation: Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota; Center for Neurobehavioral Development, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Symons
authors.forename: Issam
authors.initials: I
authors.lastname: ElGhazi
authors.forename: Brian G
authors.initials: BG
authors.lastname: Reilly
authors.forename: Chantel C
authors.initials: CC
authors.lastname: Barney
authors.forename: Leah
authors.initials: L
authors.lastname: Hanson
authors.forename: Angela
authors.initials: A
authors.lastname: Panoskaltsis-Mortari
authors.forename: Ian M
authors.initials: IM
authors.lastname: Armitage
authors.forename: George L
authors.initials: GL
authors.lastname: Wilcox
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003147:Communication Disorders; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D012463:Saliva / Q000737:chemistry*
chemical_list: D015415:Biomarkers
keywords: Developmental Disability; Metabolite; Nuclear Magnetic Resonance (NMR); Pain; Partial Least Squares Discriminant Analysis (PLS-DA); Saliva