{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:42:18Z","timestamp":1786977738081,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:00:00Z","timestamp":1493856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with recurrent pain of negative chronic stress origin from different locations have a characteristic pattern of tender points in the temporal, trapezoid, great pectoral and abdominal muscles. We tested the hypothesis that the startle reaction is activated in these children and that some of the startle\u2010activated muscles are related to the tender point pattern and the recurrent pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In children\/adolescents, aged 10\u201317\u00a0years, 19 with recurrent psychosomatic pain (\n                      <jats:styled-content style=\"fixed-case\">PAIN<\/jats:styled-content>\n                      ) and 23 controls (\n                      <jats:styled-content style=\"fixed-case\">CON<\/jats:styled-content>\n                      ) we measured and analysed resting activity and acoustic startle response with electromyography (\n                      <jats:styled-content style=\"fixed-case\">EMG<\/jats:styled-content>\n                      ) for the muscles involved in the pattern of tender points and also the lumbar erector spinae.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:styled-content style=\"fixed-case\">PAIN<\/jats:styled-content>\n                      group showed higher resting activity and higher acoustic startle response values than the\n                      <jats:styled-content style=\"fixed-case\">CON<\/jats:styled-content>\n                      group for all six muscles together regarding the mean amplitude in the initial 200\u00a0ms, and during the\n                      <jats:italic>burst<\/jats:italic>\n                      of activity, and longer\n                      <jats:italic>burst duration<\/jats:italic>\n                      and shorter\n                      <jats:italic>burst latency<\/jats:italic>\n                      . For\n                      <jats:styled-content style=\"fixed-case\">PAIN<\/jats:styled-content>\n                      versus\n                      <jats:styled-content style=\"fixed-case\">CON<\/jats:styled-content>\n                      , all separate muscles showed generally higher values of\n                      <jats:styled-content style=\"fixed-case\">EMG<\/jats:styled-content>\n                      amplitudes and burst durations, and shorter latencies for the burst onset in all measures; with significance or strong trends for several parameters and muscles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For the first time in children with recurrent psychosomatic pain, increased resting activity and potentiated startle response were demonstrated in the muscles involved in the stress tender point pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This study demonstrates in adolescents how recurrent pain of negative stress origin from the head, stomach, back and chest is related to increased startle reaction and increased muscular tension in these regions. This study contributes to the understanding of the mechanisms underlying the global burden of recurrent pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.1057","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T23:52:40Z","timestamp":1493941960000},"page":"1561-1570","source":"Crossref","is-referenced-by-count":6,"title":["Children with chronic stress\u2010induced recurrent muscle pain have enhanced startle reaction"],"prefix":"10.1002","volume":"21","author":[{"given":"G.","family":"Alfv\u00e9n","sequence":"first","affiliation":[{"name":"Clintec, Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Grillner","sequence":"additional","affiliation":[{"name":"The Department of Neuroscience Karolinska institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Andersson","sequence":"additional","affiliation":[{"name":"The Department of Neuroscience Karolinska institute Stockholm Sweden"},{"name":"Karolinska Institute and the Swedish School of Sport and Health Sciences Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2003.tb00467.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1993.tb12706.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1993.tb12728.x"},{"key":"e_1_2_8_5_1","unstructured":"Alfv\u00e9n G.(1993c).Recurrent abdominal pain of non\u2010organic origin in childhood. 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