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Abstract Details

Affective pain processing disrupted in children with posterior cerebellar tumor resection
Pain
S24 - Lost Connections: From Functional Connectivity to Needs in Pain and Palliative Care (1:22 PM-1:33 PM)
003

Acute cerebellar infarctions have been shown to lead to affective and cognitive deficits in pediatric patients. However, the consequences of cerebellar insult on pain processing are unknown. Recent evidence not only suggests that the cerebellum plays a role in affective processing, but it also demonstrates increased activity in this area when individuals experience experimental or clinical pain, particularly in the posterior cerebellum. Describing the impact of surgical intervention in this area during childhood is of particular importance, as it may alter sensory development into adulthood.

Damage to the posterior cerebellum can cause affective deficits in patients. In adults, cerebellar infarcts result in thermal hyperalgesia and affect descending modulation of pain. This study evaluated the effect of resection of low-grade cerebellar tumors on pain processing in human children.

Twelve pediatric patients treated with surgery only for low-grade gliomas (8 females, 4 males; mean age = 13.8±5.6) and twelve matched controls (8 females, 4 males; mean age = 13.8±5.7) were evaluated using quantitative sensory testing and fMRI. Five patients had tumors localized to posterior cerebellar hemispheres, henceforth identified as Crus Patients.

Crus Patients had significantly lower pain tolerance to a cold pressor test than controls. No significant differences were detected between subject groups for heat and cold detection thresholds (HDT, CDT), and heat and cold pain thresholds (HPT, CPT). Crus Patients also showed significantly decreased fMRI responses to painful heat in anterior insula and anterior cingulate. These areas have been associated with pain affect.

Damage to posterior cerebellar hemispheres disrupted affective pain processing and endogenous pain modulation, resulting in decreased pain tolerance to suprathreshold noxious stimuli. This suggests that surgical resection of this region in children may increase the risk of developing pain disorders.

Authors/Disclosures
Julie Rosner
PRESENTER
No disclosure on file
No disclosure on file
Nicole Ullrich, MD, PhD, MMSci, FAAN (Boston Children'S Hospital) Dr. Ullrich has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion Pharmaceuticals. The institution of Dr. Ullrich has received research support from Children's Tumor Foundation. Dr. Ullrich has received intellectual property interests from a discovery or technology relating to health care. Dr. Ullrich has received publishing royalties from a publication relating to health care.
No disclosure on file
No disclosure on file
Eric A. Moulton (Brain Imaging Center) No disclosure on file