Value of the central sensitisation inventory in patients with axial spondyloarthritis.

IF 5.1 2区 医学 Q1 RHEUMATOLOGY
Yvonne Maria van der Kraan, Davy Paap, Hans Timmerman, Freke Wink, Suzanne Arends, Michiel Reneman, Anneke Spoorenberg
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引用次数: 0

Abstract

Background: In many patients with axial spondyloarthritis (axSpA), pain persists despite anti-inflammatory medication. Quantitative sensory testing (QST) indirectly assesses altered somatosensory function, though its clinical practicality is limited. The Central Sensitisation Inventory (CSI) could be an alternative in the initial assessment of central sensitisation (CS). This study aimed to investigate the value of the CSI in evaluating CS in patients with axSpA by (1) assessing somatosensory function related to CS with QST and (2) exploring associations between CSI, QST, patient and disease characteristics and pain-related psychosocial factors.

Methods: Consecutive outpatients from the Groningen Leeuwarden AxSpA cohort underwent QST, including pressure pain threshold (PPT), temporal summation (TS) and conditioned pain modulation (CPM). Participants completed questionnaires assessing CS (CSI), illness perception (Revised Illness Perception Questionnaire, IPQ-R), pain-related worrying (Pain Catastrophising Scale, PCS), fatigue (Modified Fatigue Impact Scale, MFIS), anxiety/depression (Hospital Anxiety and Depression Scale, HADS) and coping. QST measurements were stratified for CSI≥40.

Results: 201 patients with axSpA were included; 63% male, 64% radiographic axSpA, median symptom duration 12 years (IQR 5-24), mean Axial Spondyloarthritis Disease Activity Score 2.1±1.0. Patients with CSI≥40 had significantly lower PPTs and higher TS than CSI<40 (p<0.004). No significant differences in CPM were observed. In multivariable linear regression, sex, PCS, IPQ-R Identity, MFIS and HADS anxiety were independently associated with CSI (78% explained variance).

Conclusion: In this large cross-sectional study in patients with axSpA, the CSI appears as a useful initial CS assessment questionnaire. When CSI scores indicate CS, considering pain-related psychosocial factors is important. These results emphasise the need for a biopsychosocial approach to manage chronic pain in patients with axSpA.

轴性脊柱关节炎患者中枢过敏清单的价值。
背景:许多轴性脊柱关节炎(axSpA)患者在服用抗炎药物后疼痛依然存在。定量感觉测试(QST)可间接评估躯体感觉功能的改变,但其临床实用性有限。中枢敏化量表(CSI)可作为初步评估中枢敏化(CS)的替代方法。本研究旨在通过(1)用 QST 评估与 CS 相关的躯体感觉功能;(2)探讨 CSI、QST、患者和疾病特征以及与疼痛相关的社会心理因素之间的关联,研究 CSI 在评估轴性脊柱后凸患者 CS 方面的价值:来自格罗宁根吕伐登 AxSpA 队列的连续门诊患者接受了 QST,包括压力痛阈值 (PPT)、时间总和 (TS) 和条件疼痛调节 (CPM)。参与者填写了评估CS(CSI)、疾病感知(疾病感知问卷修订版,IPQ-R)、疼痛相关担忧(疼痛灾难化量表,PCS)、疲劳(改良疲劳影响量表,MFIS)、焦虑/抑郁(医院焦虑抑郁量表,HADS)和应对能力的问卷。结果:共纳入 201 名 axSpA 患者;其中 63% 为男性,64% 为放射学 axSpA,中位症状持续时间为 12 年(IQR 5-24),平均轴性脊柱关节炎疾病活动度评分为 2.1±1.0。CSI≥40的患者的PPTs明显低于CSI≥40的患者,而TS则高于CSI≥40的患者:在这项针对轴性SpA患者的大型横断面研究中,CSI似乎是一个有用的初始CS评估问卷。当 CSI 评分显示 CS 时,考虑与疼痛相关的社会心理因素非常重要。这些结果表明,需要采用生物-心理-社会方法来管理轴性SpA患者的慢性疼痛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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