Vogel Matthias, Binneböse Marius, Lohmann Christoph H, Junne Florian, Berth Alexander, Riediger Christian
Department of Psychosmatic Medicine and Psychotherapy, Otto-von-Guericke-University of Magdeburg, 39120 Magdeburg, Germany.
Department of Orthopedic Surgery, Otto-von-Guericke-University of Magdeburg, 39120 Magdeburg, Germany.
J Clin Med. 2022 Feb 18;11(4):1094. doi: 10.3390/jcm11041094.
Total knee arthroplasty (TKA) bears a potential of rendering patients unsatisfied with the operation as a result of negative affectivity related to osteoarthritis and TKA. Not only is pain a lateralized experience, but negative affect and other psychosomatic correlates of pain might also be processed on grounds of lateralization. Lateralization in this context is likely linked to the amygdalae, which display differential left/right patterns of association with psychopathology. What is noteworthy is that osteoarthritis itself is linked not only to negative effects but also to childhood abuse.
The present study tests lateralization of psychosomatic correlates of knee-pain using the brief symptom inventory-18 (BSI-18), the dissociative experiences scale (FDS-20), the pain catastrophizing scale (PCS), the Tampa scale of kinesiophobia (TSK), the childhood trauma screener (CTS) and WOMAC. More precisely, we were interested in predicting the side of operations by means of the above-mentioned constructs using binary logistic regression, based on 150 participants (78 left knees) awaiting TKA for knee-osteoarthritis.
Somatization ( = 0.003), childhood abuse ( = 0.04) and pain-catastrophizing ( = 0.04) predicted operations on the right side. Anxiety ( = 0.001) and kinesiophobia ( = 0.002) predicted operations on the left side.
Knee-pain may be differentially modulated by its psychosomatic correlates as a result of lateralization and corresponding patterns of psychosomatic reagibility.
全膝关节置换术（TKA）有可能让患者因与骨关节炎和TKA相关的负面情绪而对手术不满意。疼痛不仅是一种有偏向性的体验，而且疼痛的负面情绪和其他身心相关因素也可能基于偏向性进行处理。在这种情况下，偏向性可能与杏仁核有关，杏仁核显示出与精神病理学相关的不同左右模式。值得注意的是，骨关节炎本身不仅与负面影响有关，还与童年期受虐有关。
本研究使用简明症状量表-18（BSI-18）、分离体验量表（FDS-20）、疼痛灾难化量表（PCS）、坦帕运动恐惧量表（TSK）、童年创伤筛查量表（CTS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）来测试膝关节疼痛的身心相关因素的偏向性。更确切地说，我们基于150名等待因膝关节骨关节炎进行TKA的参与者（78例左膝），有兴趣通过上述构念使用二元逻辑回归来预测手术侧别。
躯体化（=0.003）、童年期受虐（=0.04）和疼痛灾难化（=0.04）可预测右侧手术。焦虑（=0.001）和运动恐惧（=0.002）可预测左侧手术。
由于偏向性和相应的身心反应模式，膝关节疼痛可能会因其身心相关因素而受到不同的调节。
