Should central sensitization and neuropathic pain be considered in disease activity and treatment decision in axial ankylosing spondilitis?

Yıl 2019, Cilt: 44 Sayı: Ek 1, 1 - 10, 29.12.2019

Tuba Koca Hasan Göğebakan Gözde Çetin

https://doi.org/10.17826/cumj.503652

Cited By: 6

Öz

Purpose: The aim of this study was to evaluate the prevalence of central sensitization syndromes and the relation between severity of central sensitization and disease activity in patients with axial ankylosing spondylitis (AS). 

Materials and Methods: Study included 105 patients who were diagnosed with AS. Patients' age, sex, body mass index (BMI), disease duration, accompanying disease (diabetes, hypertension) were recorded. The severity of back pain was assessed by visual analog scale (VAS), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS_CRP). Central sensitization inventory (CSI) was used for central sensitization. 

Results: Central sensitization was found in 45.7% of all participants and neuropathic pain was found in 34.3% of them. When we divided the group according to the central sensitization score ≥40, we found that those who were diagnosed with central sensitization were at an advanced age and have higher BMI, higher erythrocyte sedimentation rate, longer disease duration, higher disease activity, higher neuropathic pain presence and scores than others. 

Conclusion: Central sensitization syndromes and neuropathic pain are frequently associated with AS. Positive correlations of central sensitization and neuropathic pain scores with disease activity scores support that chronic pain components should be taken into consideration in the follow-up of the disease

Anahtar Kelimeler

Ankylosing spondylitis, central sensitization, neuropathic pain, disease activity, chronic pain

Santral sensitizasyon bozukluğu aksiyel ankilozan spondilitte hastalık aktivitesini değerlendirmede dikkate alınmalı mıdır?

Öz

Amaç: Bu çalışmanın amacı, aksiyel ankilozan spondilit’li (AS) hastalarda santral sensitizasyon sendromlarının prevalansını ve santral sensitizasyonun şiddeti ile hastalık aktivitesi arasındaki ilişkinin değerlendirilmesidir. 

Gereç ve Yöntem: Çalışmamız, AS tanılı 105 hastayı içermektedir. Hastaların yaşı, cinsiyeti, vücut kitle indeksi (VKİ), hastalık süresi, eşlik eden hastalık (diyabet, hipertansiyon) kaydedildi. Bel ağrısının şiddeti görsel analog skala (VAS) ile, hastalık aktivitesi Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), Bath Ankilozan Spondilit Fonksiyonel İndeks (BASFI) ve Ankilozan Spondilit Hastalık Aktivite Skoru-C-reaktif protein (ASDAS_CRP) ile değerlendirildi.  Santral sensitizasyon için santral sensitizasyon envanteri (CSI) kullanıldı.

Bulgular: Tüm katılımcıların %45.7'sinde santral sensitizasyon, (SS) % 34.3'ünde nöropatik ağrı saptandı. Grubu santral sensitizasyon skoru ≥40'a göre ayırdığımızda, santral sensitizasyon tanısı alanlarda ileri yaş, yüksek VKI, yüksek eritrosit sedimentasyon hızı (ESR), uzun hastalık süresi, yüksek hastalık aktivitesi), yüksek nöropatik ağrı varlığı ve skorları tespit ettik..

Sonuç: Santral sensitizasyon sendromları ve nöropatik ağrı sıklıkla AS ile ilişkilidir. Santral sensitizasyon ve nöropatik ağrı skorlarının hastalık aktivite skorları ile pozitif korelasyonu, hastalık takibinde kronik ağrı bileşenlerinin dikkate alınması gerektiğini desteklemektedir.

Anahtar Kelimeler

Ankilozan spondilit, nöropatik ağrı, hastalık aktivitesi, kronik ağrı, santral sensitizasyon

Kaynakça

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