An Evaluation of Central Sensitization in Patients With Sickle Cell Disease

JOURNAL OF PAIN

卷:17

Article

Campbell, Claudia M.¹  Moscou-Jackson, Gyasi³  Carroll, C. Patrick¹  Kiley, Kasey¹  Haywood, Carlton, Jr.²  Lanzkron, Sophie²  Hand, Matthew¹  Edwards, Robert R.^4,5,6,7,8  Haythornthwaite, Jennifer A.¹ 

[1] Johns Hopkins Univ, Dept Psychiat & Behav Sci, Sch Med, 5510 Nathan Shock Dr,Suite 100, Baltimore, MD 21224 USA

[2] Johns Hopkins Univ, Div Hematol, Sch Med, Baltimore, MD 21224 USA

[3] Johns Hopkins Univ, Sch Nursing, Baltimore, MD 21224 USA

[4] Harvard Univ, Sch Med, Dept Anesthesiol, Chestnut Hill, MA USA

[5] Harvard Univ, Sch Med, Dept Perioperat, Chestnut Hill, MA USA

[6] Harvard Univ, Sch Med, Dept Pain Med, Chestnut Hill, MA USA

[7] Harvard Univ, Sch Med, Dept Psychiat, Chestnut Hill, MA USA

[8] Brigham & Womens Hosp, Pain Management Ctr, Chestnut Hill, MA USA

关键词: Sickle cell disease;    clinical pain;    laboratory pain;    quantitative sensory testing;    central sensitization;    sleep;    catastrophizing;   

DOI  :  10.1016/j.jpain.2016.01.475

来源: Elsevier

【 摘 要 】

Central sensitization (CS), nociceptive hyperexcitability known to amplify and maintain clinical pain, has been identified as a leading culprit responsible for maintaining pain in several chronic pain conditions. Recent evidence suggests that it may explain differences in the symptom experience of individuals with sickle cell disease (SCD). Quantitative sensory testing (QST) can be used to examine CS and identify individuals who may have a heightened CS profile. The present study categorized patients with SCD on the basis of QST responses into a high or low CS phenotype and compared these groups according to measures of clinical pain, vaso-occlusive crises, psychosocial factors, and sleep continuity. Eighty-three adult patients with SCD completed QST, questionnaires, and daily sleep and pain diaries over a 3-month period, weekly phone calls for 3 months, and monthly phone calls for 12 months. Patients were divided into CS groups (ie, no/low CS [n = 17] vs high CS En = 21]), on the basis of thermal and mechanical temporal summation and aftersensations, which were norm-referenced to 47 healthy control subjects. High CS subjects reported more clinical pain, vaso-occlusive crises, catastrophizing, and negative mood, and poorer sleep continuity (Ps < .05) over the 18-month follow-up period. Future analyses should investigate whether psychosocial disturbances and sleep mediate the relationship between CS and pain outcomes. (C) 2016 by the American Pain Society

【 授权许可】

Free