Departamento de Enfermería, Universidad de Cantabria, Santander, Spain; Grupo de Investigación en Enfermería, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain; Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
J Pain. 2024 Sep;25(9):104533. doi: 10.1016/j.jpain.2024.104533. Epub 2024 Apr 7.
The aims of this study were to phenotype pain in patients with interstitial lung disease (ILD) by investigating the association between sensitization-associated symptoms with quality of life, anxiety/depression, pain catastrophizing, and kinesiophobia levels and identifying those risk factors explaining the variance of quality of life in individuals with ILD and pain. One hundred and thirty-two (38.6% women, mean age: 70, standard deviation: 10.5 years) patients with ILD completed clinical (age, sex, height, weight), psychological (Hospital Anxiety and Depression Scale [HADS] and the Pittsburgh Sleep Quality Index), and health-related quality of life (EQ-5D-5L) variables, as well as the Central Sensitization Inventory (CSI), the Self-Report Leeds Assessment of Neuropathic Symptoms (S-LANSS), Pain Catastrophizing Scale, and Tampa Scale for Kinesiophobia (TSK-11) questionnaires. The prevalence of sensitization-associated symptomatology (CSI), neuropathic-like features (S-LANSS), anxiety symptoms, depressive symptoms, or poor sleep was 20.5%, 23.5%, 23.6%, 22.9%, or 51.6%. Significant associations between CSI, S-LANSS, HADS-A, HADS-D, Pain Catastrophizing Scale, TSK-11, and EQ-5D-5L (.220 < r < .716) were found. The regression analysis revealed that CSI, TSK-11, and HADS-D explained 44.8% of the variance of EQ-5D-5L (r adjusted: .448). This study found the presence of sensitization-associated and neuropathic-like symptoms as well as other central nervous system-derived symptoms, such as anxiety, depression, poor sleep, pain catastrophizing, and kinesiophobia in 25% of ILD patients with pain. Sensitization-associated symptoms, depression, and kinesiophobia were associated with a worse quality of life. These findings would support that individuals with ILD can exhibit different pain phenotypes, including nociplastic-like pain phenotype based on self-reported measurements. PERSPECTIVE: Pain in patients with ILD can fulfill features of different phenotypes, including nociplastic pain, when sensory, emotional, and cognitive mechanisms are involved at the same time.
本研究的目的是通过研究与敏感性相关的症状与生活质量、焦虑/抑郁、疼痛灾难化和运动恐惧症水平之间的关系,对间质性肺疾病(ILD)患者的疼痛进行表型分析,并确定那些可以解释ILD 伴疼痛患者生活质量差异的风险因素。132 名(38.6%为女性,平均年龄:70 岁,标准差:10.5 岁)ILD 患者完成了临床(年龄、性别、身高、体重)、心理(医院焦虑和抑郁量表 [HADS] 和匹兹堡睡眠质量指数)和健康相关生活质量(EQ-5D-5L)变量,以及中枢敏化量表(CSI)、自我报告的莱斯特感觉神经病变症状评估(S-LANSS)、疼痛灾难化量表和坦帕运动恐惧症量表(TSK-11)问卷。存在与敏感性相关的症状(CSI)、类神经病变特征(S-LANSS)、焦虑症状、抑郁症状或睡眠质量差的患者比例分别为 20.5%、23.5%、23.6%、22.9%或 51.6%。CSI、S-LANSS、HADS-A、HADS-D、疼痛灾难化量表、TSK-11 和 EQ-5D-5L 之间存在显著相关性(.220<r<.716)。回归分析显示,CSI、TSK-11 和 HADS-D 可以解释 EQ-5D-5L 44.8%的方差(调整后的 r:.448)。本研究发现,25%的ILD 伴疼痛患者存在与敏感性相关和类神经病变样症状以及其他源自中枢神经系统的症状,如焦虑、抑郁、睡眠质量差、疼痛灾难化和运动恐惧症。与敏感性相关的症状、抑郁和运动恐惧症与较差的生活质量相关。这些发现支持ILD 患者可能表现出不同的疼痛表型,包括基于自我报告测量的类伤害感受性疼痛表型。观点:ILD 患者的疼痛可以表现出不同的表型特征,包括伤害感受性疼痛,同时涉及感觉、情感和认知机制。