Little is known about the sensory and neurobiological basis of chronic self-injurious behavior (SIB) among individuals with intellectual and developmental disabilities (IDD). In behavioral models of SIB, sensory mechanisms function as putative positive or negative automatic reinforcers but there is little evidence directly linking behavioral and biological mechanisms. Evidence from both clinical and animal studies of chronic pain and its behavioral sequelae supports the hypothesis that some forms of SIB may be regulated by altered pain mechanisms. From our work and that of others, we know that pain can lead to SIB in this population but we know almost nothing about whether chronic SIB leads to pain and the resulting neuro-immune cascade of effects. An established body of preclinical and clinical literature and the investigator's preliminary data provide initial support for a working sensory dysfunction and neuropathic-pain like hypothesis of chronic SIB and point to an important role for the peripheral and central mechanisms of pain and inflammatory/immune activity. The purpose of this project is to begin testing a novel model of SIB in relation to chronic neuropathic-like pain due to inflammatory and immune system activation. We hypothesize that there will be a subgroup of individuals with chronic SIB that have significantly (a) altered peripheral sensory innveration, (b) increased inflammatory and immune activity, and (c) increased immune-mediated 'sickness'like behavior. A case-control design will be used to compare matched (age, gender, IQ) groups of children with IDD with (n = 40) and without SIB (n = 40). The groups will be compared on measures of (a) peripheral innervation (Aim 1), (b) inflammatory/immune cytokines and related peptides (Aim 2), and (c) functional indicators of 'sickness'-like behavior including adaptive/social behavior, sleeping/eating, and sensory reactivity and pain signs/symptoms as well as within SIB group comparisons of functional and structural variables (Aim 3). Our preliminary results suggest that, at least in the periphery, ongoing neuro-immune interactions may, in part, be related to the as of yet poorly understood pathophysiology of chronic self-injury. This study will provide the first opportunity to systematically investigate neuro-immune variables in relation to SIB among children with IDD.

Public Health Relevance

Self-injurious behavior (SIB) among individuals with intellectual and developmental disabilities (IDD) is a significant public health problem. For a considerable subgroup of individuals, treatment options may be limited by a lack of understanding about the basic sensory neurobiology related to chronic pain. The purpose of this study is to discover whether there are basic differences in sensory and pain neurobiology between children with IDD with and without SIB.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD044763-08
Application #
8241617
Study Section
Special Emphasis Panel (ZRG1-BBBP-C (02))
Program Officer
Oster-Granite, Mary Lou
Project Start
2003-07-01
Project End
2015-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
8
Fiscal Year
2012
Total Cost
$447,738
Indirect Cost
$140,403
Name
University of Minnesota Twin Cities
Department
Psychology
Type
Schools of Education
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
Peters, Sarika U; Byiers, Breanne J; Symons, Frank J (2016) Diurnal Salivary Cortisol and Regression Status in MECP2 Duplication Syndrome. J Child Neurol 31:159-63
Symons, Frank J; Tervo, Raymond C; Barney, Chantel C et al. (2015) Peripheral Innervation in Children With Global Developmental Delay: Biomarker for Risk for Self-Injurious Behavior? J Child Neurol 30:1722-7
Barney, Chantel C; Feyma, Timothy; Beisang, Arthur et al. (2015) Pain experience and expression in Rett syndrome: Subjective and objective measurement approaches. J Dev Phys Disabil 27:417-429
Barney, Chantel C; Hoch, John; Byiers, Breanne et al. (2015) A Case-controlled Investigation of Pain Experience and Sensory Function in Neuronal Ceroid Lipofuscinosis. Clin J Pain 31:998-1003
Symons, Frank J; Byiers, Breanne; Hoch, John et al. (2015) Infrared Thermal Analysis and Individual Differences in Skin Temperature Asymmetry in Rett Syndrome. Pediatr Neurol 53:169-72
Symons, Frank J; Gilles, Elizabeth; Tervo, Raymond et al. (2014) Skin and self-injury: a possible link between peripheral innervation and immune function? Dev Med Child Neurol :
Shinde, Satomi K; Danov, Stacy; Chen, Chin-Chih et al. (2014) Convergent validity evidence for the Pain and Discomfort Scale (PADS) for pain assessment among adults with intellectual disability. Clin J Pain 30:536-43
Symons, Frank J; Roberts, Jane E (2013) Biomarkers, behavior, and intellectual and developmental disabilities. Am J Intellect Dev Disabil 118:413-5
Symons, Frank J; Byiers, Breanne; Tervo, Raymond C et al. (2013) Parent-reported pain in Rett syndrome. Clin J Pain 29:744-6
Byiers, Breanne; Symons, Frank (2013) The need for unbiased cognitive assessment in Rett syndrome: is eye tracking the answer? Dev Med Child Neurol 55:301-2

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