Central Sensitization in Patients with Rheumatoid Arthritis: A Systematic Literature Review

被引：155

作者：

Meeus, Mira ^{[1
,2
]}

Vervisch, Stijn ^{[1
]}

De Clerck, Luc S. ^{[3
]}

Moorkens, Greta ^{[4
]}

Hans, Guy ^{[5
]}

Nijs, Jo ^{[1
,2
,6
]}

机构：

[1] Vrije Univ Brussel, Dept Human Physiol, Fac Phys Educ & Physiotherapy, B-1050 Brussels, Belgium

[2] Artesis Univ Coll Antwerp AHA, Div Musculoskeletal Physiotherapy, Higher Inst Physiotherapy, Dept Hlth Care Sci, Antwerp, Belgium

[3] Univ Antwerp, Dept Immunol Allergy & Rheumatol, B-2020 Antwerp, Belgium

[4] Univ Hosp Antwerp UZA, Dept Internal Med, Antwerp, Belgium

[5] Univ Hosp Antwerp UZA, Multidisciplinary Pain Ctr PCT, Antwerp, Belgium

[6] Univ Hosp Brussels, Dept Rehabil & Physiotherapy, Brussels, Belgium

来源：

SEMINARS IN ARTHRITIS AND RHEUMATISM | 2012年 / 41卷 / 04期

关键词：

pain inhibition; chronic pain; central sensitization; pain processing; rheumatoid arthritis; systematic review; CHRONIC-FATIGUE-SYNDROME; PRESSURE-PAIN THRESHOLD; FIBROMYALGIA; HYPERALGESIA; INFLAMMATION; MECHANISMS; RESPONSES; ANIMALS; QUALITY; TRIALS;

D O I：

10.1016/j.semarthrit.2011.08.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: The goal of the present study is to systematically review the scientific literature addressing central sensitization and central nociceptive processing in patients with rheumatoid arthritis (RA). Methods: To identify relevant articles, we searched PubMed and Web of Science. The search strategy was a combination of terms of the following groups: "Rheumatoid arthritis," inflammatory joint pain, or arthritis; AND (central) sensitization, (central) hypersensitivity, central hyperexcitability, pain modulation, pain processing, neural inhibition, or pain physiopathology; AND pain, nociception, hyperalgesia, pain threshold, or algometry. Articles fulfilling the inclusion criteria were screened for methodologic quality with specific checklists to evaluate different study designs (2 independent raters). Results: Twenty-four full-text articles were included, of which the majority were case-control studies, followed by nonsystematic reviews, cross-sectional studies, and case reports. Methodologic quality was very heterogeneous. Preliminary evidence for generalized hyperalgesia in RA is available. In addition, the mechanism behind impaired central nociceptive processing remains rather obscure. The role of cytokines and neuropeptides especially remains to be elucidated. Windup appears to develop more easily in RA, but evidence in support of impaired nociceptive inhibition and cognitive emotional sensitization (sensitization due to cognitive bias) is scarce. Conclusions: The symmetrical manifestation of the disease, the poor relation between disease activity and symptoms, and the generalized hyperalgesia at both articular and nonarticular sites for different kinds of stimuli are indicative of the presence of central sensitization in RA patients. Further research is required to provide firm evidence in support of various aspects of central sensitization in humans with RA. (C) 2012 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 41:556-567

引用

页码：556 / 567

页数：12

共 41 条

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