Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sampling
2.2. Clinical Variables
2.3. Outcome Measures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Kimak, A.; Robak, E.; Makowska, J.; Woźniacka, A. Psoriatic Arthritis: Development, Detection and Prevention: A Scoping Review. J. Clin. Med. 2023, 12, 3850. [Google Scholar] [CrossRef] [PubMed]
- Husni, E.; Michael, M. Epidemiology of Psoriatic Arthritis; Oxford University Press: Oxford, UK, 2018; Volume 1. [Google Scholar]
- Snoeck Henkemans, S.V.J.; de Jong, P.H.P.; Luime, J.J.; Kok, M.R.; Tchetverikov, I.; Kasiem, F.R.; Welby, S.; Prickett, A.R.; van der Helm-van Mil, A.H.M.; Vis, M.; et al. Importance of quick attainment of minimal disease activity for a positive impact on lives of patients with psoriatic arthritis. RMD Open 2022, 8, e002706. [Google Scholar] [CrossRef] [PubMed]
- Rahman, P.; Zummer, M.; Bessette, L.; Baer, P.; Haraoui, B.; Chow, A.; Kelsall, J.; Kapur, S.; Rampakakis, E.; Psaradellis, E.; et al. Real-world validation of the minimal disease activity index in psoriatic arthritis: An analysis from a prospective, observational, biological treatment registry. BMJ Open 2017, 7, e016619. [Google Scholar] [CrossRef] [PubMed]
- Conaghan, P.G.; Alten, R.; Deodhar, A.; Sullivan, E.; Blackburn, S.; Tian, H.; Gandhi, K.; Jugl, S.M.; Strand, V. Relationship of pain and fatigue with health-related quality of life and work in patients with psoriatic arthritis on TNFi: Results of a multi-national real-world study. RMD Open 2020, 6, e001240. [Google Scholar] [CrossRef]
- Hackett, S.; Coates, L.C. Outcome measures in psoriatic arthritis: Where next? Musculoskelet. Care 2022, 20, S22–S31. [Google Scholar] [CrossRef]
- Freynhagen, R.; Parada, H.A.; Calderon-Ospina, C.A.; Chen, J.; Rakhmawati Emril, D.; Fernández-Villacorta, F.J.; Franco, H.; Ho, K.Y.; Lara-Solares, A.; Li, C.C.; et al. Current understanding of the mixed pain concept: A brief narrative review. Curr. Med. Res. Opin. 2019, 35, 1011–1018. [Google Scholar] [CrossRef]
- Minhas, D.; Clauw, D.J. Pain Mechanisms in Patients with Rheumatic Diseases. Rheum. Dis. Clin. N. Am. 2021, 47, 133–148. [Google Scholar] [CrossRef]
- Kosek, E.; Cohen, M.; Baron, R.; Gebhart, G.F.; Mico, J.A.; Rice, A.S.C.; Rief, W.; Sluka, A.K. Do we need a third mechanistic descriptor for chronic pain states? Pain 2016, 157, 1382–1386. [Google Scholar] [CrossRef]
- Raja, S.N.; Carr, D.B.; Cohen, M.; Finnerup, N.B.; Flor, H.; Gibson, S.; Keefe, F.J.; Mogil, J.S.; Ringkamp, M.; Sluka, K.A.; et al. The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain 2020, 161, 1976–1982. [Google Scholar] [CrossRef]
- Popkirov, S.; Enax-Krumova, E.K.; Mainka, T.; Hoheisel, M.; Hausteiner-Wiehle, C. Functional pain disorders—more than nociplastic pain. NeuroRehabilitation 2020, 47, 343–353. [Google Scholar] [CrossRef]
- Nijs, J.; Lahousse, A.; Kapreli, E.; Bilika, P.; Saraçoğlu, İ.; Malfliet, A.; Coppieters, I.; De Baets, L.; Leysen, L.; Roose, E.; et al. Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future. J. Clin. Med. 2021, 10, 3203. [Google Scholar] [CrossRef] [PubMed]
- Trouvin, A.P.; Attal, N.; Perrot, S. Assessing central sensitization with quantitative sensory testing in inflammatory rheumatic diseases: A systematic review. Jt. Bone Spine 2022, 89, 105399. [Google Scholar] [CrossRef]
- Scerbo, T.; Colasurdo, J.; Dunn, S.; Unger, J.; Nijs, J.; Cook, C. Measurement Properties of the Central Sensitization Inventory: A Systematic Review. Pain Pract. 2018, 18, 544–554. [Google Scholar] [CrossRef] [PubMed]
- Adami, G.; Gerratana, E.; Atzeni, F.; Benini, C.; Vantaggiato, E.; Rotta, D.; Idolazzi, L.; Rossini, M.; Gatti, D.; Fassio, A. Is central sensitization an important determinant of functional disability in patients with chronic inflammatory arthritides? Ther. Adv. Musculoskelet. Dis. 2021, 13, 1759720X2199325. [Google Scholar] [CrossRef] [PubMed]
- Gottlieb, A.B.; Chaudhari, U.; Baker, D.G.; Perate, M.; Dooley, L.T. The National Psoriasis Foundation Psoriasis Score (NPF-PS) system versus the Psoriasis Area Severity Index (PASI) and Physician’s Global Assessment (PGA): A comparison. J. Drugs Dermatol. 2003, 2, 260–266. [Google Scholar]
- van Gestel, A.M.; Haagsma, C.J.; van Riel, P.L. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998, 41, 1845–1850. [Google Scholar] [CrossRef]
- Eberl, G.; Studnicka-Benke, A.; Hitzelhammer, H.; Gschnait, F.; Smolen, J.S. Development of a disease activity index for the assessment of reactive arthritis (DAREA). Rheumatology 2000, 39, 148–155. [Google Scholar] [CrossRef]
- Mayer, T.G.; Neblett, R.; Cohen, H.; Howard, K.J.; Choi, Y.H.; Williams, M.J.; Perez, Y.; Gatchel, R.J. The development and psychometric validation of the central sensitization inventory. Pain Pract. 2012, 12, 276–285. [Google Scholar] [CrossRef]
- Neblett, R.; Hartzell, M.M.; Mayer, T.G.; Cohen, H.; Gatchel, R.J. Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory. Pain Pract. 2017, 17, 166–175. [Google Scholar] [CrossRef]
- Düzce Keleş, E.; Birtane, M.; Ekuklu, G.; Kılınçer, C.; Çalıyurt, O.; Taştekin, N.; Is, E.E.; Ketenci, A.; Neblett, R. Validity and reliability of the Turkish version of the central sensitization inventory. Arch. Rheumatol. 2021, 36, 518–526. [Google Scholar] [CrossRef]
- Spitzer, R.L.; Kroenke, K.; Williams, J.B.W.; Löwe, B. A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7. Arch. Intern. Med. 2006, 166, 1092–1097. [Google Scholar] [CrossRef]
- Konkan, R.; Şenormancı, Ö.; Güçlü, O.; Aydın, E.; Sungur, M.Z. Validity and Reliability Study for the Turkish Adaptation of the Generalized Anxiety Disorder-7 (GAD-7) Scale. Arch. Neuropsychiatry 2013, 50, 53–58. [Google Scholar] [CrossRef]
- Morin, C.M.; Belleville, G.; Bélanger, L.; Ivers, H. The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011, 34, 601–608. [Google Scholar] [CrossRef]
- Boysan, M.; Güleç, M.; Beşiroğlu, L.; Kalafat, M. Psychometric properties of the Insomnia Severity Index in Turkish sample. Anatol. J. Psychiatry 2010, 11, 248–252. [Google Scholar]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The PHQ-9. J. Gen. Intern. Med. 2001, 16, 606–613. [Google Scholar] [CrossRef]
- Sari, Y.E.; Kökoğlu, B.; Balcıoğlu, H.; Bilge, U. Turkish reliability of the patient health questionnaire-9. Biomed. Res. 2016, 27, 460–462. [Google Scholar]
- Fries, J.F.; Spitz, P.W.; Young, D.Y. The dimensions of health outcomes: The health assessment questionnaire, disability and pain scales. J. Rheumatol. 1982, 9, 789–793. [Google Scholar]
- Küçükdeveci, A.A.; Sahin, H.; Ataman, S.; Griffiths, B.; Tennant, A. Issues in cross-cultural validity: Example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Care Res. 2004, 51, 14–19. [Google Scholar] [CrossRef]
- Zhuo, M. Descending facilitation. Mol. Pain 2017, 13, 1744806917699212. [Google Scholar] [CrossRef]
- Latremoliere, A.; Woolf, C.J. Central sensitization: A generator of pain hypersensitivity by central neural plasticity. J. Pain 2009, 10, 895–926. [Google Scholar] [CrossRef] [PubMed]
- Soni, A.; Wanigasekera, V.; Mezue, M.; Cooper, C.; Javaid, M.K.; Price, A.J.; Tracey, I. Central Sensitization in Knee Osteoarthritis: Relating Presurgical Brainstem Neuroimaging and PainDETECT-Based Patient Stratification to Arthroplasty Outcome. Arthritis Rheumatol. 2019, 71, 550–560. [Google Scholar] [CrossRef]
- Steen Pettersen, P.; Neogi, T.; Magnusson, K.; Berner Hammer, H.; Uhlig, T.; Kvien, T.K.; Haugen, I.K. Peripheral and Central Sensitization of Pain in Individuals With Hand Osteoarthritis and Associations With Self-Reported Pain Severity. Arthritis Rheumatol. 2019, 71, 1070–1077. [Google Scholar] [CrossRef] [PubMed]
- Meeus, M.; Vervisch, S.; De Clerck, L.S.; Moorkens, G.; Hans, G.; Nijs, J. Central Sensitization in Patients with Rheumatoid Arthritis: A Systematic Literature Review. Semin. Arthritis Rheum. 2012, 41, 556–567. [Google Scholar] [CrossRef]
- Ayar, K.; Ökmen, B.M.; Altan, L.; Öztürk, E.K. Central sensitization and its relationship with health profile in Behçet’s disease. Mod. Rheumatol. 2021, 31, 474–480. [Google Scholar] [CrossRef]
- Metin Ökmen, B.; Ayar, K.; Altan, L.; Yeşilöz, Ö. Central sensitisation in primary Sjögren Syndrome and its effect on sleep quality. Mod. Rheumatol. 2022, 32, 908–914. [Google Scholar] [CrossRef]
- Salaffi, F.; Farah, S.; Bianchi, B.; Di Carlo, M. Central Sensitization in Psoriatic Arthritis: Relationship With Composite Measures of Disease Activity, Functional Disability, and Health-Related Quality of Life. J. Rheumatol. 2024, 51, 144–149. [Google Scholar] [CrossRef]
- Zhao, S.S.; Duffield, S.J.; Goodson, N.J. The prevalence and impact of comorbid fibromyalgia in inflammatory arthritis. Best Pract. Res. Clin. Rheumatol. 2019, 33, 101423. [Google Scholar] [CrossRef] [PubMed]
- Bellinato, F.; Gisondi, P.; Fassio, A.; Girolomoni, G. Central Pain Sensitization in Patients with Chronic Plaque Psoriasis. Dermatol. Ther. 2023, 13, 1149–1156. [Google Scholar] [CrossRef]
- Yücel, F.N.; Gezer, H.H.; Jandaulyet, J.; Öz, N.; Acer Kasman, S.; Duruöz, M.T. Clinical and functional impact of central sensitization on patients with familial Mediterranean fever: A cross-sectional study. Rheumatol. Int. 2023, 43, 125–136. [Google Scholar] [CrossRef] [PubMed]
- Aykurt Karlıbel, I.; Kasapoğlu Aksoy, M. The relationship between central sensitization and disease activity, quality of life, and sleep quality among patients with axial spondyloarthritis. Ir. J. Med. Sci. 2023, 192, 481–489. [Google Scholar] [CrossRef]
Characteristics | CSI Score ≥ 40 (n = 67) | CSI Score < 40 (n = 36) | p |
---|---|---|---|
Male, n (%) | 31 (46.3) | 11 (30.6) | 0.122 |
Age, years, mean (SD) | 42.6 (5.4) | 44.2 (8.6) | 0.325 |
Current smoker, n (%) | 20 (29.9) | 16 (44.4) | 0.139 |
BMI, kg/m2, mean (SD) | 27.3 (3.3) | 25.2 (4.3) | 0.014 * |
High education level a, n (%) | 41 (61.2) | 15 (41.7) | 0.065 |
Age at diagnosis, years, mean (SD) | 38.3 (5.7) | 39.5 (7.7) | 0.422 |
Time since diagnosis, years, median (IQR) | 4 (2) | 4 (3) | 0.100 |
HLA-B27 positivity, n (%) | 21 (31.3) | 10 (27.8) | 0.823 |
Family history of psoriasis, n (%) | 25 (37.3) | 6 (16.7) | 0.014 * |
History of IBD, n (%) | 2 (2.9) | 2 (5.6) | 0.500 |
History of uveitis, n (%) | 16 (23.9) | 5 (13.9) | 0.382 |
Entheseal involvement, n (%) | 41 (61.2) | 15 (41.7) | 0.058 |
Peripheral arthritis, n (%) | 20 (29.9) | 10 (27.8) | 0.825 |
Sacroiliac joint involvement, n (%) | 21 (31.3) | 10 (27.8) | 0.823 |
NSAID, n (%) | 54 (80.5) | 26 (72.2) | 0.330 |
csDMARDs, n (%) | 47 (70.1) | 31 (86.1) | 0.072 |
boDMARDs, n (%) | 21 (31.3) | 16 (44.4) | 0.186 |
ESR (mm/h), mean (SD) | 21.4 (8.5) | 20.8 (10.2) | 0.722 |
CRP (mg/L), mean (SD) | 13.1 (4.6) | 11.5 (7.4) | 0.246 |
DAPSA, mean (SD) | 19.8 (6.4) | 10.9 (5.6) | <0.001 * |
PASI, mean (SD) | 12.9 (3.6) | 7.1 (2.7) | <0.001 * |
DAS28, mean (SD) | 3.4 (0.8) | 2.8 (0.6) | <0.001 * |
CSI Score ≥ 40 (n = 67) | CSI Score < 40 (n = 36) | p | |
---|---|---|---|
CSI Part B | |||
1: restless leg syndrome, n (%) | 5 (7.5) | 1 (2.8) | 0.333 |
2: chronic fatigue syndrome, n (%) | 5 (7.5) | 2 (5.6) | 0.714 |
3: fibromyalgia, n (%) | 9 (13.4) | 1 (2.8) | 0.082 |
4: temporomandibular joint disorder, n (%) | 0 (0.0) | 0 (0.0) | |
5: migraine or tension headaches, n (%) | 4 (6.0) | 2 (5.6) | 0.932 |
6: irritable bowel syndrome, n (%) | 6 (9.0) | 2 (5.6) | 0.539 |
7: multiple chemical sensitivities, n (%) | 0 (0.0) | 0 (0.0) | |
8: neck injury (including whiplash), n (%) | 0 (0.0) | 0 (0.0) | |
9: anxiety or panic attacks, n (%) | 4 (6.0) | 1 (2.8) | 0.472 |
10: depression | 7 (10.4) | 2 (5.6) | 0.402 |
GAD-7, mean (SD) | 9.8 (3.5) | 4.2 (2.2) | <0.001 * |
PHQ-9, mean (SD) | 15.1 (5.6) | 8.1 (1.8) | <0.001 * |
ISI, mean (SD) | 16.7 (5.8) | 8.4 (3.4) | <0.001 * |
HAQ, mean (SD) | 12.6 (44) | 7.2 (1.4) | <0.001 * |
Subclinical (n = 16) (I) | Mild (n = 20) (II) | Moderate (n = 27) (III) | Severe (n = 25) (IV) | Excessive (n = 15) (V) | p | Post hoc | |
---|---|---|---|---|---|---|---|
BMI, kg/m2, mean (SD) | 23.10 (4.3) | 26.97 (3.6) | 27.08 (2.5) | 27.29 (3.9) | 27.80 (3.5) | 0.001 * | I vs. III-IV-V |
DAPSA, mean (SD) | 5.87 (2.8) | 15.00 (3.5) | 17.44 (4.1) | 20.3 (4.5) | 23.1 (10.2) | <0.001 * | I vs. II-III-IV-V, II-V |
PASI, mean (SD) | 5.26 (1.6) | 8.40 (2.6) | 11.1 (0.6) | 12.9 (1.6) | 16.4 (6.1) | <0.001 * | I vs. III-IV-V, II vs. IV-V, V vs. III-IV |
DAS28, mean (SD) | 2.68 (0.9) | 2.90 (0.1) | 3.03 (0.1) | 3.59 (0.7) | 4.09 (1.3) | <0.001 * | I vs. IV-V, V vs. II-III |
GAD-7, mean (SD) | 2.00 (0.8) | 6.00 (0.7) | 8.44 (2.7) | 10.10 (2.4) | 11.87 (5.1) | <0.001 * | I vs. II-III-IV-V, II vs. IV-V, III-V |
PHQ-9, mean (SD) | 6.62 (1.3) | 9.25 (1.1) | 12.49 (3.9) | 12.80 (3.3) | 23.67 (1.3) | <0.001 * | I vs. III-IV-V, II vs. IV-V, V vs. III-IV |
ISI, mean (SD) | 5.00 (0.8) | 11.25 (1.5) | 12.19 (1.5) | 18.84 (5.8) | 21.4 (5.1) | <0.001 * | I vs. II-III-IV-V, II vs. IV-V, III-V |
HAQ, mean (SD) | 7.87 (1.7) | 6.75 (0.8) | 11.60 (3.1) | 12.40 (3.4) | 15.00 (6.8) | <0.001 * | I vs. IV-V, II vs. III-IV-V |
Correlation Coefficient | p | |
---|---|---|
BMI, kg/m2 | 0.265 | 0.007 * |
DAPSA | 0.569 | <0.001 * |
PASI | 0.652 | <0.001 * |
DAS28 | 0.393 | <0.001 * |
GAD-7 | 0.652 | <0.001 * |
PHQ-9 | 0.586 | <0.001 * |
ISI | 0.614 | <0.001 * |
HAQ | 0.578 | <0.001 * |
Covariate | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
OR | p | 95% CI (Lower-Upper) | OR | p | 95% CI (Lower–Upper) | |
BMI, kg/m2 | 1.16 | 0.009 | 1.04–1.31 | |||
DAPSA | 1.33 | <0.001 | 1.18–1.50 | |||
PASI | 2.32 | <0.001 | 1.69–3.19 | 9.70 | 0.017 * | 1.52–62.21 |
DAS28 | 7.22 | 0.001 | 2.24–23.31 | |||
GAD-7 | 2.19 | <0.001 | 1.54–3.10 | 2.89 | 0.014 * | 1.24–6.71 |
PHQ-9 | 1.68 | <0.001 | 1.34–2.10 | |||
ISI | 1.42 | <0.001 | 1.23–1.65 | 5.56 | 0.041 * | 1.08–28.72 |
HAQ | 1.92 | <0.001 | 1.45–2.56 |
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Kaya, M.N.; Tecer, D.; Kılıç, Ö.; Özgünen, M.S.; Yılmaz, S. Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis. Medicina 2024, 60, 1449. https://doi.org/10.3390/medicina60091449
Kaya MN, Tecer D, Kılıç Ö, Özgünen MS, Yılmaz S. Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis. Medicina. 2024; 60(9):1449. https://doi.org/10.3390/medicina60091449
Chicago/Turabian StyleKaya, Mehmet Nur, Duygu Tecer, Özlem Kılıç, Merve Sungur Özgünen, and Sedat Yılmaz. 2024. "Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis" Medicina 60, no. 9: 1449. https://doi.org/10.3390/medicina60091449