Increased Auditory Startle Reflex in Children with Functional Abdominal Pain

Bakker, Mirte J.; Boer, Frits; Benninga, Marc A.; Koelman, Johannes H.T.M.; Tijssen, Marina A.J.

doi:10.1016/j.jpeds.2009.08.045

« Previous Next »The Journal of Pediatrics
Volume 156, Issue 2 , Pages 285-291.e1, February 2010

Increased Auditory Startle Reflex in Children with Functional Abdominal Pain

Mirte J. Bakker, PhD
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam; Amsterdam, The Netherlands
- Reprint requests: Dr Mirte Bakker, Department of Psychiatry, St Radboud University Medical Hospital, Department of Psychiatry, 6500 HB Nijmegen, The Netherlands.
Frits Boer, MD, PhD
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam; Amsterdam, The Netherlands
Marc A. Benninga, MD, PhD
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Johannes H.T.M. Koelman, MD, PhD
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Marina A.J. Tijssen, MD, PhD
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Received 24 February 2009; received in revised form 11 June 2009; accepted 21 August 2009. published online 21 October 2009.

Objective

To test the hypothesis that children with abdominal pain–related functional gastrointestinal disorders have a general hypersensitivity for sensory stimuli.

Study design

Auditory startle reflexes were assessed in 20 children classified according to Rome III classifications of abdominal pain–related functional gastrointestinal disorders (13 irritable bowel syndrome [IBS], 7 functional abdominal pain syndrome; mean age, 12.4 years; 15 girls) and 23 control subjects (14 girls; mean age, 12.3 years) using a case-control design. The activity of 6 left-sided muscles and the sympathetic skin response were obtained by an electromyogram. We presented sudden loud noises to the subjects through headphones.

Results

Both the combined response of 6 muscles and the blink response proved to be significantly increased in patients with abdominal pain compared with control subjects. A significant increase of the sympathetic skin response was not found. Comorbid anxiety disorders (8 patients with abdominal pain) or Rome III subclassification did not significantly affect these results.

Conclusions

This study demonstrates an objective hyperresponsivity to nongastrointestinal stimuli. Children with abdominal pain–related functional gastrointestinal disorders may have a generalized hypersensitivity of the central nervous system.

ASR, Auditory startle reflex, EMG, Electromyography, IBS, Irritable bowel syndrome