Uçkun Aslı Çalışkan, Doğan Nesibe, İnce Buğra, Akçay Şeniz, Kaya Taciser, Karatepe Altınay Göksel
Department of Physical Medicine and Rehabilitation, İzmir City Hospital, İzmir, Turkey.
Department of Physical Medicine and Rehabilitation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
Chronobiol Int. 2025 Jul;42(7):913-920. doi: 10.1080/07420528.2025.2515990. Epub 2025 Jun 9.
Low back pain is a leading cause of disability, with over 85% of cases classified as non-specific (NSLBP). Beyond mechanical causes, central sensitization (CS) has been recognized as a key mechanism in chronic pain. This study investigated the relationship between chronotype (morning, intermediate, evening) and CS severity in NSLBP patients, and whether chronotype is associated with pain intensity and disability. A total of 131 patients (aged 18-65) were assessed using the Morningness-Eveningness Questionnaire (MEQ), Central Sensitization Inventory (CSI), Pain Catastrophizing Scale (PCS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Visual Analogue Scale (VAS), and Roland-Morris Disability Questionnaire (RMDQ). Three-way ANCOVA (controlling for age, gender, and occupation) revealed that evening-type individuals had significantly higher CSI, PCS, BDI, PSQI, and RMDQ scores (all < 0.05). Hierarchical regression analysis showed that evening chronotype (β = 0.193, = 0.004), pain catastrophizing (β = 0.508, < 0.001), and depressive symptoms (β = 0.435, < 0.001) were independent predictors of CS severity. These findings suggest that eveningness is associated with more severe central sensitization and adverse psychosocial outcomes in NSLBP. Chronotype may play a role in pain modulation and should be considered in assessment and management strategies.
腰痛是导致残疾的主要原因，超过85%的病例被归类为非特异性下腰痛（NSLBP）。除了机械性原因外，中枢敏化（CS）已被认为是慢性疼痛的关键机制。本研究调查了NSLBP患者的昼夜节律类型（早晨型、中间型、晚上型）与CS严重程度之间的关系，以及昼夜节律类型是否与疼痛强度和残疾相关。总共131名患者（年龄在18 - 65岁之间）使用晨型-夜型问卷（MEQ）、中枢敏化量表（CSI）、疼痛灾难化量表（PCS）、贝克抑郁量表（BDI）、匹兹堡睡眠质量指数（PSQI）、视觉模拟量表（VAS）和罗兰-莫里斯残疾问卷（RMDQ）进行评估。三因素协方差分析（控制年龄、性别和职业）显示，晚上型个体的CSI、PCS、BDI、PSQI和RMDQ得分显著更高（均P < 0.05）。分层回归分析表明，晚上型昼夜节律（β = 0.193，P = 0.004）、疼痛灾难化（β = 0.508，P < 0.001）和抑郁症状（β = 0.435，P < 0.001）是CS严重程度的独立预测因素。这些发现表明，晚上型昼夜节律与NSLBP中更严重的中枢敏化和不良心理社会结果相关。昼夜节律类型可能在疼痛调节中起作用，在评估和管理策略中应予以考虑。
