title: Quantitative sensory testing of temperature, pain, and touch in adults with Down syndrome.
abstract: The spinothalamic pathway mediates sensations of temperature, pain, and touch. These functions seem impaired in children with Down syndrome (DS), but have not been extensively examined in adults. The objective of the present study was to compare the spinothalamic-mediated sensory functions between adults with DS and adults from the general population and to examine in the DS group the relationship between the sensory functions and level of intellectual functioning. Quantitative sensory testing (QST) was performed in 188 adults with DS (mean age 37.5 years) and 142 age-matched control participants (median age 40.5 years). Temperature, pain, and touch were evaluated with tests for cold-warm discrimination, sharp-dull discrimination (pinprick), and tactile threshold, respectively. Level of intellectual functioning was estimated with the Social Functioning Scale for Intellectual Disability (intellectual disability level) and the Wechsler Preschool and Primary Scale of Intelligence--Revised (intelligence level). Overall, the difference in spinothalamic-mediated sensory functions between the DS and control groups was not statistically significant. However, DS participants with a lower intelligence level had a statistically significant lower performance on the sharp-dull discrimination test than DS participants with higher intelligence level (adjusted p=.006) and control participants (adjusted p=.017). It was concluded that intellectual functioning level is an important factor to take into account for the assessment of spinothalamic-mediated sensory functioning in adults with DS: a lower level could coincide with impaired sensory functioning, but could also hamper QST assessment.
authors.affiliation: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Electronic address: nc.de.knegt@vu.nl.
authors.forename: Nanda
authors.initials: N
authors.lastname: de Knegt
authors.affiliation: Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: rutidef@post.tau.ac.il.
authors.forename: Ruth
authors.initials: R
authors.lastname: Defrin
authors.affiliation: Department of Clinical Child and Family Studies, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Electronic address: c.schuengel@vu.nl.
authors.forename: Carlo
authors.initials: C
authors.lastname: Schuengel
authors.affiliation: Department of Oral Kinesiology, Academic Center for Dentistry Amsterdam (ACTA) , Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands. Electronic address: f.lobbezoo@acta.nl.
authors.forename: Frank
authors.initials: F
authors.lastname: Lobbezoo
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: h.evenhuis@erasmusmc.nl.
authors.forename: Heleen
authors.initials: H
authors.lastname: Evenhuis
authors.affiliation: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Electronic address: eja.scherder@vu.nl.
authors.forename: Erik
authors.initials: E
authors.lastname: Scherder
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology*; D017288:Pain Threshold; D012684:Sensory Thresholds; D012720:Severity of Illness Index; D020886:Somatosensory Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013133:Spinothalamic Tracts / Q000503:physiopathology*; D013697:Thermosensing / Q000502:physiology; D014110:Touch / Q000502:physiology; D055815:Young Adult
keywords: Down syndrome; Pain experience; Quantitative sensory testing; Somatosensory system; Spinothalamic pathway