Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia.
Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Curr Rheumatol Rev. 2023;19(4):479-487. doi: 10.2174/1573397119666230327115316.
To assess central sensitization in young patients with spondyloarthritis (SpA) and to study the associated factors with higher central sensitization scores.
This was a cross-sectional study including patients with SpA (ASAS criteria) aged less than 50 years. For all patients, we collected the sociodemographic and disease characteristics data. Central sensitization was assessed using a validated tool: The Central Sensitization inventory (CSI). Pain status, fibromyalgia, quality of life, anxiety and depression were screened by the Brief pain inventory, the Fibromyalgia rapid screening tool (FiRST), the ASQoL, and the Hospital anxiety and depression scale (HAD) anxiety and depression. Univariable and multivariable linear regression analyses were performed to achieve our objective.
Seventy-two patients were enrolled (65,2% males). The median age was 39 (28,25-46) years. Median BASDAI and ASDAS-CRP scores were 3 (2.1 - 4.7) and 2.7 (1.9 - 3.48), respectively. The median value of the CSI score was 15 (6,25-33,75); a CSI≥40 was noted in 15.3% of patients. Depression, anxiety scores, fibromyalgia and impaired QoL were screened in 11%, 9,7%, 9,7%, and 44,4%, respectively. CSI≥40 was positively correlated with ASQoL, FiRST, HAD anxiety, HAD depression and the 5 categories of pain interference (mood, regular work, relationships, sleep and enjoyment of life). Multivariate analysis identified a predictive model which included the combination of FiRST, BASDAI and ASQoL. First was the strongest predictive factor of a higher central sensitization.
CS is frequent among SpA patients and should be looked for in order to improve QoL.
评估年轻的脊柱关节炎（SpA）患者的中枢敏化，并研究与更高中枢敏化评分相关的因素。
这是一项横断面研究，纳入了年龄小于 50 岁的符合 ASAS 标准的 SpA 患者。所有患者均收集社会人口学和疾病特征数据。使用经过验证的工具评估中枢敏化：中枢敏化量表（CSI）。疼痛状况、纤维肌痛、生活质量、焦虑和抑郁通过简明疼痛量表、纤维肌痛快速筛查工具（FiRST）、ASQoL 和医院焦虑抑郁量表（HAD）焦虑和抑郁进行筛查。进行单变量和多变量线性回归分析以达到我们的目的。
共纳入 72 例患者（65.2%为男性）。中位年龄为 39 岁（28.25-46）。BASDAI 和 ASDAS-CRP 评分的中位数分别为 3（2.1-4.7）和 2.7（1.9-3.48）。CSI 评分中位数为 15（6，25-33.75）；15.3%的患者 CSI≥40。抑郁、焦虑评分、纤维肌痛和生活质量受损分别在 11%、9.7%、9.7%和 44.4%的患者中筛查到。CSI≥40 与 ASQoL、FiRST、HAD 焦虑、HAD 抑郁和 5 类疼痛干扰（情绪、正常工作、人际关系、睡眠和享受生活）呈正相关。多变量分析确定了一个预测模型，包括 FiRST、BASDAI 和 ASQoL 的组合。首先是更高中枢敏化的最强预测因素。
CS 在 SpA 患者中很常见，应加以关注以提高生活质量。
