Peculiarities of chronic pain syndrome in patients with ankylosing spondylitis


DOI: https://dx.doi.org/10.18565/therapy.2018.7-8.82-88

E.S. Filatov, Sh.F. Erdes

«V.A. Nasonova research institute of rheumatology» FSBSI, Moscow
Signs of central sensitization in the form of neuropathic pain descriptors were identified in various rheumatological diseases: fibromyalgia, rheumatoid arthritis, and osteoarthritis. At the same time, interdisciplinary studies in ankylosing spondylitis are still having identity character. The purpose of the study is to identify neuropathic descriptors in patients with ankylosing spondylitis (AS) and their connection with the disease. Material and methods. The study involved 150 patients with AS. Rheumatological status (disease activity and functional disorders according to BASDAI, BASFI and BASMI indexes), neurological status, pain intensity according to the visual analogue scale (VAS), neuropathic pain questionnaires (DN4, Pain DETECT), emotional-affective sphere estimation (HADS) ) and assessment of life quality of patients according to the questionnaire EQ-5D were estimated. Results. The neuropathic component of pain (NCP) was determined in 13% (n = 19) of patients with DN4 ≥ 4 and in 20% (30 people) with Pain DETECT. The group of patients with DN4 ≥ 4 had more intense pain on the VAS scale (6.01 ± 1.91 vs 4.39 ± 2.05, p = 0.001), significantly higher disease activity (BASDAI 6.74 ± 1.61 vs 4.67 ± 2.17, p = 0.002) and functional disorders (BASFI 5.84 ± 2.27 vs 3.83 ± 2.78, p = 0.02), with a higher anxiety (10.69 ± 1, 97 vs 5.94 ± 3.53, p = 0.001) and depression (7.54 ± 4.12 vs 4.31 ± 2.28, p = 0.001). However, current neurological examination revealed no damage of the somatosensory nervous system.
Conclusions. The identification of neuropathic pain descriptors in a number of AS patients in the absence of neurological disorders allows to discuss the involvement of central sensitization in the pain pathogenesis.
Keywords: ankylosing spondylitis, neuropathic descriptors, central sensitization
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    • About the Autors

    Ekaterina S. Filatova, PhD., rheumatologist, research scientist of the laboratory of spondylitis of «V.A. Nasonova research institute of rheumatology» FSBSI. Address: 115522, Moscow, 34 A Kashirskoye schosse St.
    Tel.: +74956625040. E-mail: Es-filatova@mail.ru
    Shandor F. Erdes, MD, professor, rheumatologist, head of the laboratory of spondylitis of «V.A. Nasonova research institute of rheumatology» FSBSI. Address: 115522, Moscow, 34 A Kashirskoye schosse St. Tel.: +74956625040.

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