An Evaluation of Central Sensitization in Patients With Sickle Cell Disease
An Evaluation of Central Sensitization in Patients With Sickle Cell Disease
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DOI：
10.1016/j.jpain.2016.01.475
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发表时间：
2016-05-01
期刊：
影响因子：
4
通讯作者：
Haythornthwaite, Jennifer A.
中科院分区：
文献类型：
--
作者：
Campbell, Claudia M.;Moscou-Jackson, Gyasi;Haythornthwaite, Jennifer A.
中枢敏化（CS），即已知会放大和维持临床疼痛的伤害性过度兴奋，已被确定为导致多种慢性疼痛状况下疼痛的主要原因。最近的证据表明，它可以解释镰状细胞病（SCD）患者症状体验的差异。定量感官测试 (QST) 可用于检查 CS 并识别可能具有较高 CS 特征的个体。本研究根据 QST 反应将 SCD 患者分为高 CS 表型或低 CS 表型，并根据临床疼痛、血管闭塞危象、心理社会因素和睡眠连续性的测量结果对这些组进行比较。 83 名患有 SCD 的成年患者完成了 3 个月内的 QST、问卷调查、每日睡眠和疼痛日记、3 个月内每周通话以及 12 个月内每月通话。根据热和机械时间总和和后感觉，将患者分为 CS 组（即无/低 CS [n = 17] 与高 CS En = 21]），这些结果以 47 名健康对照受试者为常模参考。高 CS 受试者在 18 个月的随访期间报告了更多的临床疼痛、血管闭塞危机、灾难性情绪和消极情绪，以及较差的睡眠连续性 (Ps < .05)。未来的分析应该调查社会心理障碍和睡眠是否介导 CS 和疼痛结果之间的关系。 (C) 2016 年，美国疼痛协会
Central sensitization (CS), nociceptive hyperexcitability known to amplify and maintain clinical pain, has been identified as a leading culprit responsible for maintaining pain in several chronic pain conditions. Recent evidence suggests that it may explain differences in the symptom experience of individuals with sickle cell disease (SCD). Quantitative sensory testing (QST) can be used to examine CS and identify individuals who may have a heightened CS profile. The present study categorized patients with SCD on the basis of QST responses into a high or low CS phenotype and compared these groups according to measures of clinical pain, vaso-occlusive crises, psychosocial factors, and sleep continuity. Eighty-three adult patients with SCD completed QST, questionnaires, and daily sleep and pain diaries over a 3-month period, weekly phone calls for 3 months, and monthly phone calls for 12 months. Patients were divided into CS groups (ie, no/low CS [n = 17] vs high CS En = 21]), on the basis of thermal and mechanical temporal summation and aftersensations, which were norm-referenced to 47 healthy control subjects. High CS subjects reported more clinical pain, vaso-occlusive crises, catastrophizing, and negative mood, and poorer sleep continuity (Ps < .05) over the 18-month follow-up period. Future analyses should investigate whether psychosocial disturbances and sleep mediate the relationship between CS and pain outcomes. (C) 2016 by the American Pain Society