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

Autor:	van der Kraan YM; Department of Rheumatology and Clinical Immunology, University Medical Centre, Groningen, Netherlands y.m.van.der.kraan@umcg.nl., Paap D; Department of Rheumatology and Clinical Immunology, University Medical Centre, Groningen, Netherlands.; Department of Physiotherapy, Saxion University of Applied Sciences, Enschede, Netherlands., Timmerman H; Department of Anaesthesiology, Pain Center, University Medical Centre, Groningen, Netherlands., Wink F; Department of Rheumatology, Medical Centre, Leeuwarden, Netherlands., Arends S; Department of Rheumatology and Clinical Immunology, University Medical Centre, Groningen, Netherlands., Reneman M; Rehabilitation Medicine, University Medical Centre, Groningen, Netherlands., Spoorenberg A; Department of Rheumatology and Clinical Immunology, University Medical Centre, Groningen, Netherlands.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 Oct 28; Vol. 10 (4). Date of Electronic Publication: 2024 Oct 28.
DOI:	10.1136/rmdopen-2024-004528
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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