Tip 2 Diabetes Mellitusta Anksiyete ve Depresyon: Sinir İletim Çalışması ve Nöropatik Ağrıyı İçeren Bir Çalışma

Year 2023, Volume: 25 Issue: 1, 76 - 84, 30.04.2023

Şencan Buturak Halit Fidancı Mehmet Yıldız Zülfikar Arlıer

https://doi.org/10.24938/kutfd.1113995

Abstract

Amaç: Nöropati, nöropatik ağrı ve psikiyatrik bozuklukların diabetes mellitus (DM) ile ilişkili olduğu bilinmektedir. Sinir iletim çalışması bulguları ile nöropatik ağrı, depresyon ve anksiyete arasında bir ilişki olup olmadığının ortaya çıkarılması amaçlandı.

Gereç ve Yöntemler: Bu çalışmaya Eylül 2021 ile Ocak 2022 tarihleri arasında klinik nörofizyoloji laboratuvarımıza başvuran Tip 2 DM hastaları dahil edildi. Hastalara median, ulnar, sural, peroneal ve posterior tibial sinir iletim çalışmaları yapıldı. Hastalara nöropatik ağrıyı değerlendirmek için 4 Soru nöropatik ağrı anketi (DN4) uygulandı. Hastalara Hastane Anksiyete ve Depresyon Ölçeği (HADS) uygulandı. HADS'ın iki alt bölümü olan anksiyete (HADS-A) ve depresyon (HADS-D) puanları analizlere dahil edildi.

Bulgular: Çalışmaya 40 DM hastası (27 erkek, 13 kadın) dahil edildi. Hastaların yaş ortalaması 57.9±12.7 (min-maks 23-83) yıl idi. Nöropatik ağrısı olan, nörofizyolojik bulgulara göre polinöropatisi olan, HADS-A ve HADS-D skorları anormal olan hasta sayısı sırasıyla 32 (%80), 23 (%58), 17 (%43) ve 24 (%60) idi. Nöropatik ağrı, polinöropatisi olan ve olmayan sırasıyla 22 (%96) ve 10 (%59) hastada mevcuttu. Depresyonu olan 22 (%92) hastada ve depresyonu olmayan 16 (%63) hastada nöropatik ağrı saptandı (p=0.046). Nöropatik ağrısı olan hastalarda median, ulnar ve sural sinirlerin bileşik sinir aksiyon potansiyeli amplitüdleri nöropatik ağrısı olmayanlara göre daha düşüktü (p=0.011, p=0.027, p<0.001).

Sonuç: Bu çalışmada Tip 2 DM hastalarında nöropatik ağrı, depresyon ve anksiyetenin görülebileceği ortaya konmuştur. Ek olarak bu çalışma, duyusal sinir iletim çalışmaları ve nöropatik ağrı arasında bir ilişki olduğunu göstermiştir. Ayrıca nöropatik ağrının depresyonu olan DM hastalarda, depresyonu olmayan DM hastalarına göre daha yaygın olduğu sonucuna varıldı.

Keywords

Anksiyete, depresyon, diabetes mellitus, sinir iletim çalışması, nöropatik ağrı

ANXIETY AND DEPRESSION IN TYPE 2 DIABETES MELLITUS: A STUDY INCLUDING NERVE CONDUCTION STUDY AND NEUROPATHIC PAIN

Abstract

Objective: It is known that neuropathy, neuropathic pain and psychiatric disorders are associated with diabetes mellitus (DM). It was aimed to find out whether there is a relationship between nerve conduction study findings, neuropathic pain, depression and anxiety.

Material and Methods: Type 2 DM patients that applied to our clinical neurophysiology laboratory between September 2021 and January 2022 were included in this study. Median, ulnar, sural, peroneal and posterior tibial nerve conduction studies were performed on the patients. Douleur Neuropathique 4 Questions (DN4) was applied to the patients to evaluate neuropathic pain. Hospital Anxiety and Depression Scale (HADS) was applied to the patients. Anxiety (HADS-A) and depression (HADS-S) scores, which are the two subsections of HADS, were included in the analysis.

Results: Forty DM patients (27 males, 13 females) were included in the study. The mean age of the patients was 57.9±12.7 (min-max 23-83) years. The number of patients with neuropathic pain, polyneuropathy according to neurophysiological findings, abnormal HADS-A and HADS-D scores were 32 (80%), 23 (58%), 17 (43%), and 24 (60%), respectively. Neuropathic pain was present in 22 (96%) and 10 (59%) of the patients with and without polyneuropathy, respectively. Neuropathic pain was found in 22 (92%) patients with depression and 16 (63%) patients without depression (p=0.046). Among patients with neuropathic pain, compound nerve action potential amplitudes of median, ulnar and sural nerves were lower than those without neuropathic pain (p=0.011, p=0.027, p<0.001).

Conclusion: In this study, it was revealed that neuropathic pain, depression and anxiety can be seen in Type 2 DM patients. In addition, this study showed a relationship between sensory nerve conduction studies and neuropathic pain. It was also concluded that neuropathic pain was more common in DM patients with depression than in patients without depression.

Keywords

Anxiety, depression, diabetes mellitus, nerve conduction study, neuropathic pain

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