{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T23:30:49Z","timestamp":1792539049033,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,25]],"date-time":"2017-02-25T00:00:00Z","timestamp":1487980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Dutch Organization for Scientific Research","award":["023.002.094"],"award-info":[{"award-number":["023.002.094"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Lowered pressure\u2010pain thresholds have been demonstrated in adults with Ehlers\u2010Danlos syndrome hypermobility type (EDS\u2010HT), but whether these findings are also present in children is unclear. Therefore, the objectives of the study were to determine whether generalized hyperalgesia is present in children with hypermobility syndrome (HMS)\/EDS\u2010HT, explore potential differences in pressure\u2010pain thresholds between children and adults with HMS\/EDS\u2010HT, and determine the discriminative value of generalized hyperalgesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were classified in 1 of 3 groups: HMS\/EDS\u2010HT, hypermobile (Beighton score \u22654 of 9), and healthy controls. Descriptive data of age, sex, body mass index, Beighton score, skin laxity, and medication usage were collected. Generalized hyperalgesia was quantified by the average pressure\u2010pain thresholds collected from 12 locations. Confounders collected were pain locations\/intensity, fatigue, and psychological distress. Comparisons between children with HMS\/EDS\u2010HT and normative values, between children and adults with HMS\/EDS\u2010HT, and corrected confounders were analyzed with multivariate analysis of covariance. The discriminative value of generalized hyperalgesia employed to differentiate between HMS\/EDS\u2010HT, hypermobility, and controls was quantified with logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly lower pressure\u2010pain thresholds were found in children with HMS\/EDS\u2010HT compared to normative values (range \u221222.0% to \u221259.0%; <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.05). When applying a threshold of 30.8 N\/cm<jats:sup>2<\/jats:sup> for males and 29.0 N\/cm<jats:sup>2<\/jats:sup> for females, the presence of generalized hyperalgesia discriminated between individuals with HMS\/EDS\u2010HT, hypermobility, and healthy controls (odds ratio 6.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Children and adults with HMS\/EDS\u2010HT are characterized by hypermobility, chronic pain, and generalized hyperalgesia. The presence of generalized hyperalgesia may indicate involvement of the central nervous system in the development of chronic pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22998","type":"journal-article","created":{"date-parts":[[2016,8,3]],"date-time":"2016-08-03T10:40:52Z","timestamp":1470220852000},"page":"421-429","source":"Crossref","is-referenced-by-count":50,"title":["Generalized Hyperalgesia in Children and Adults Diagnosed With Hypermobility Syndrome and Ehlers\u2010Danlos Syndrome Hypermobility Type: A Discriminative Analysis"],"prefix":"10.1002","volume":"69","author":[{"given":"M. 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