Age and sex Differences in Pediatric Neuropathic Pain and Complex Regional Pain Syndrome

Author:

Mesaroli Giulia1,Davidge Kristen M.2,Davis Aileen M.3,Perruccio Anthony V.4,Choy Samantha5,Walker Suellen M.6,Stinson Jennifer N.7

Affiliation:

1. Department of Physical Therapy, University of Toronto; Department of Rehabilitation, The Hospital for Sick Children and Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada

2. Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON, Canada

3. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health and Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

4. Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, and Department of Surgery, University of Toronto, Toronto, ON, Canada

5. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

6. UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK

7. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada

Abstract

Background: Age and sex differences may exist in the frequency (incidence, prevalence) or symptoms of neuropathic pain (NP) and complex regional pain syndrome (CRPS) due to biopsychosocial factors (e.g., neurodevelopment, physiological and hormonal changes, psychosocial differences) that evolve through childhood and adolescence.2 Age and sex differences may have implications for evaluating screening and diagnostic tools and treatment interventions. Objective: To map the existing literature on pediatric NP and CRPS with respect to age and sex distributions, and age and sex differences in symptomology and frequency. Methods: A scoping literature review was conducted. Databases were searched from inception to January 2023. Data were collected on study design, setting, demographics, and age and sex differences in frequency and symptoms. Results: Eighty-seven studies were included. Distribution of participants with CRPS (n=37 studies) was predominantly early adolescence (10–14 years) and female sex, while NP (n=42 studies) was most commonly reported throughout adolescence (10–19 years) in both sexes. Forty-one studies examined age and sex differences in frequency; 6 studies reported higher frequency in adolescence. Very few studies (n=11) examined differences in symptomology. Discussion: Large epidemiological studies are required to further understand age and sex differences in frequency of pediatric NP and CRPS. Age and sex differences must be considered when evaluating screening and diagnostic tools and treatment interventions to ensure relevance and validity to both sexes and across ages. Validated tools will improve understanding of age- and sex-dependent differences in symptoms, pathophysiology, and psychosocial impact of pediatric NP and CRPS.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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