Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey.
Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey.
J Steroid Biochem Mol Biol. 2020 Feb;196:105488. doi: 10.1016/j.jsbmb.2019.105488. Epub 2019 Oct 4.
Vitamin D replacement helps in pain reduction in patients with chronic widespread pain (CWP). But the current literature lack studies that investigate its mechanism. Cutaneous silent period (CSP) is the electrophysiologic analog of the spinal inhibitory pathways and an objective method to document their involvement. This study aims to show if vitamin D replacement has an effect on the spinal inhibitory pathways through CSP parameters. Female patients who have CWP with vitamin D deficiency were included. Patients received an 8-week replacement therapy of vitamin D. Patients' pain were evaluated using the visual analog scale (VAS) and Leeds assessment of neuropathic symptoms and signs pain scale (LANSS). Quality of life with Nottingham Health Profile (NHP) and CSP parameters were also recorded before and after treatment. A total of 51 patients were included in the final analyses. The mean age of the patients was 44.3 ± 12.7 (minimum 18-maximum 65). Mean symptom duration was 13.1 ± 6.7 (minimum3-maximum 24) months. Patients' mean BMI was 21.6 ± 3.9 (minimum 18.0 maximum 29.1). Patients' median VAS and LANSS scores decreased significantly (p < 0.01) and NHP scores improved significantly in all subsets (p < 0.01). Vitamin D replacement did not significantly change CSP latency and duration (p = 0.06 and p = 0.12).Vitamin D replacement does not seem to work via modifying the spinal inhibitory pathways that are involved in the formation of the cutaneous silent period. This is the first study to objectively investigate the effect of vitamin D replacement on central sensitization mechanisms.
维生素 D 替代治疗有助于减轻慢性广泛性疼痛（CWP）患者的疼痛。但目前的文献缺乏研究其机制的研究。皮肤静息期（CSP）是脊髓抑制途径的电生理模拟，是记录其参与的客观方法。本研究旨在通过 CSP 参数显示维生素 D 替代是否对脊髓抑制途径有影响。纳入维生素 D 缺乏的 CWP 女性患者。患者接受 8 周的维生素 D 替代治疗。使用视觉模拟量表（VAS）和利兹神经病症状和体征疼痛量表（LANSS）评估患者的疼痛。治疗前后还记录了生活质量的诺丁汉健康状况表（NHP）和 CSP 参数。共有 51 例患者纳入最终分析。患者的平均年龄为 44.3 ± 12.7（最小 18-最大 65）。平均症状持续时间为 13.1 ± 6.7（最小 3-最大 24）个月。患者的平均 BMI 为 21.6 ± 3.9（最小 18.0-最大 29.1）。患者的 VAS 和 LANSS 评分中位数显著降低（p < 0.01），所有亚组的 NHP 评分均显著改善（p < 0.01）。维生素 D 替代治疗并未显著改变 CSP 潜伏期和持续时间（p = 0.06 和 p = 0.12）。维生素 D 替代治疗似乎并未通过改变参与皮肤静息期形成的脊髓抑制途径起作用。这是第一项客观研究维生素 D 替代对中枢敏化机制影响的研究。
