The role of disease activity as a determinant of body awareness and central sensitization in patients with axial spondyloarthritis: a cross-sectional study

Abstract

Aims: The aim of this study was to investigate the effects of disease activity on body awareness and central sensitization in patients with axial spondyloarthritis (axSpA). Methods: This cross-sectional study included patients diagnosed with axSpA. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and a score of four or higher was considered high disease activity. Patients were divided into two groups according to BASDAI: high disease activity (BASDAI ≥ 4) group (HG) and the low disease activity (BASDAI<4) group (LG). Body awareness levels were assessed with the Body Awareness Questionnaire (BAQ). The Central Sensitization Inventory (CSI) was used for central sensitivity. Simple linear regression analyses were performed to investigate which of the independent variables could explain the disease activity. Results: Sixty-two patients with a mean disease duration of 10.8 years were included. The mean BASDAI, CSI-A, and BAQ were 4.2, 38.5, and 73 points, respectively. Demographics and clinical characteristics were comparable between the groups (p>0.05). The CSI-A score was higher in HG compared to LG (44 (31-54) vs. 31 (21-41), p=0.008). The HG had poorer BAQ scores than the LG (61 (52-85) vs. 85 (64-96), p=0.017). BASDAI was moderately associated with CSI-A (r=0.145, R2=0.172, p=0.001). No significant correlation was found between BASDAI and BAQ (p=0.167). The results of the simple linear regression analysis suggested that CSI-A explained 17.2% of the disease activity. BASDAI (β = 0.415, p=0.001) significantly predicted central sensitization. BASDAI was strongly correlated with VAS (r=0.665, R2= 0.442, p<0.001). The VAS explained 44.2% of the disease activity, and BASDAI (r=0.665, p<0.001) significantly predicted pain severity. Conclusion: High disease activity adversely affects central sensitization and body awareness in patients with axSpA. Physicians should also consider a multimodal biopsychosocial perspective in the management of patients with high disease activity.

Keywords

• Central sensitization
• spondyloarthritis
• awareness
• pain

Thanks

None.

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