Annual Meeting Reviews

Whose Pain Is It Anyway? Exploring the Neurobiological Basis of Pediatric Pain

By Galaxy Li, MD
Chief, Division of Pain Medicine
Department of Anesthesiology
Nemours Children’s Specialty Clinics
Jacksonville, Florida

Dr. Maria Fitzgerald delivered the Keynote Address from Great Britain, where she is Professor of Developmental Neurobiology in the Division of Biosciences at University College London.  She opened by highlighting the contributions of various specialists in exploring, diagnosing, and treating pediatric pain, acknowledging ten fields of study from nurses to neonatologists, and from anesthesiologists to pharmacologists. 

Despite the multimodal and interdisciplinary approaches, the rhetorical title to her talk ultimately saluted the millions of children across the world who actually experience the pain.  She outlined that we now have much data to supplement our observational pain scales and trends in vital signs when self-report was not available, in the form of fMRI, EEG, EMG, and more. 

Dr. Fitzgerald described recent studies that observed lower pain thresholds in infants and children than in their older counterparts as well as a tendency for neuronal sensitization to noxious stimuli in early life compared to inhibition in older subjects.  Philosophically, she explored potential purposes of pain in early life.  Dr. Fitzgerald shared some of her own current laboratory work in which she is detecting changes in cortical connectivity in adult rats exposed to pain in early life, contending that they experience increased pain intensity with the same noxious stimuli.  In step with the theme of our meeting, she eloquently concluded her memorable Keynote Address with a tribute to outstanding women in pediatric pain over the decades since the 1980s. 

Dr. Fitzgerald lectured in 2014 about short- and long- term consequences of pain in infancy and childhood for our inaugural SPPM meeting in Fort Lauderdale, FL and as she did for this meeting, she also led a separate, lively roundtable discussion.  Her return to our virtual meeting was a highlight for many attendees and we hope to see her again soon!