{"doi":"10.1016/j.sjpain.2017.08.001","title":"Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia","abstract":"Abstract\n Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.\n \n Methods\n We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.\n \n \n Results\n \n Static thermal testing using cold stimuli showed lower pain thresholds (\n p\n = 0.04) and tolerance (\n p\n = 0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (\n p\n < 0.0001) and change in scores with temporal summation at the heat pain threshold (\n p\n = 0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (\n p\n = 0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512 mN) were significantly greater (\n p\n = 0.004 and\n p\n = 0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (\n p\n = 0.002 and 0.003).\n \n \n \n Conclusions\n Exaggerated temporal summation responses provide evidence of central sensitization in SCA.\n \n \n Implications\n The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.\n ","journal":"Scandinavian Journal of Pain","year":2017,"id":655625,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1711496,"name":"Kathleen J. Vaughan","orcid":null,"position":1,"is_corresponding":false},{"id":1711497,"name":"Katherine Roskom","orcid":null,"position":2,"is_corresponding":false},{"id":974572,"name":"Cassie Seamon","orcid":null,"position":3,"is_corresponding":false},{"id":1711498,"name":"Lena Diaw","orcid":null,"position":4,"is_corresponding":false},{"id":1711499,"name":"Meghan Quinn","orcid":null,"position":5,"is_corresponding":false},{"id":512847,"name":"Anna Conrey","orcid":null,"position":6,"is_corresponding":false},{"id":363290,"name":"Alan N. Schechter","orcid":"0000-0002-5235-9408","position":7,"is_corresponding":false},{"id":369594,"name":"Jennifer A. Haythornthwaite","orcid":"0000-0002-5924-7580","position":8,"is_corresponding":false},{"id":517030,"name":"Myron A. Waclawiw","orcid":null,"position":9,"is_corresponding":false},{"id":315142,"name":"Gwenyth R. Wallen","orcid":"0000-0001-7134-1636","position":10,"is_corresponding":false},{"id":590654,"name":"Inna Belfer","orcid":"0000-0001-8985-3082","position":11,"is_corresponding":false},{"id":1711500,"name":"James G. Taylor VI","orcid":null,"position":12,"is_corresponding":false},{"id":482948,"name":"Deepika S. Darbari","orcid":"0000-0002-0698-2936","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia.","abstract":"

Background and aims

Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain.

Methods

We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls.

Results

Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p<0.0001) and change in scores with temporal summation at the heat pain threshold (p=0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (p=0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512mN) were significantly greater (p=0.004 and p=0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (p=0.002 and 0.003).

Conclusions

Exaggerated temporal summation responses provide evidence of central sensitization in SCA.

Implications

The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"28969994","pmcid":"PMC5726893","openalex_id":null,"authors":[],"funders":[{"funder_name":"NHLBI NIH HHS","grant_id":"P50 HL118006","title":null},{"funder_name":"Intramural NIH HHS","grant_id":"ZIA HL006160","title":null},{"funder_name":"National Institutes of Health","grant_id":"1 ZIA HL006160 05","title":null},{"funder_name":"NHLBI Intramural Research program","grant_id":"","title":null},{"funder_name":"NHLBI","grant_id":"","title":null},{"funder_name":"Howard University College of Medicine","grant_id":"","title":null}],"total_grants":6,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"green","license":null,"oa_locations":[{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/5726893","host_type":"repository"}],"fields_of_study":[],"mesh_terms":["Humans","Hyperalgesia","Anemia, Sickle Cell","Fetal Hemoglobin","Prospective Studies","Pain Threshold","Touch","Adult","Female","Male","Cold Temperature","Hot Temperature","Chronic Pain","Central Nervous System Sensitization"],"keywords":["Pain","Central sensitization","Fetal Hemoglobin","Sickle Cell Anemia","Temporal Summation"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-11T18:21:06.530465Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}