目的:小纤维神经病(SFN)是一种明确定义的慢性疼痛状况,会导致严重的个人和社会负担。虽然已经描述了情绪障碍,尚未对SFN患者的认知和行为特征进行调查。
方法:34名疼痛的SFN患者接受了综合认知,行为,心理,生活质量(QoL),和使用经过验证的问卷进行人格评估。作为对照样品,我们纳入了36例病因混合的疼痛性周围神经病变(PPN)患者和30例健康对照(HC).神经性疼痛的临床措施,持续时间,频率,并记录评估时的疼痛强度.进行组间和相关性分析,并对多重比较进行校正。
结果:在SFN和PPN之间没有发现临床测量的差异,所有组的认知特征相似.与PPN和HC相比,SFN患者表现出更高水平的焦虑和述情障碍(p<0.005),还考虑疼痛强度。适应不良的应对策略以两组患者为特征,但只有SFN显示对疼痛的接受程度更高(p<.05)。疼痛强度和神经性症状与情绪有关,低QoL和灾难性(p<.001),特别是,感知到的疼痛强度越高,适应不良应对策略的使用率越高(p<.001)。人格评估在SFN和PPN中均显示出明显的无价值感和躯体化特征(p<.002vs.HC)。
结论:我们的结果表明,SFN患者具有正常的认知特征,虽然他们的行为特征是情绪障碍,述情障碍,适应不良的应对策略,和可怜的QoL,和其他慢性疼痛一样,可能与疼痛强度有关。人格评估表明,躯体化和无价值的感觉,这可能会使神经心理学状况恶化,在考虑患者的治疗方法时,值得临床关注。同时,高水平的疼痛接受度对于基于心理支持的治疗方法是有希望的.
Small fiber neuropathy (SFN) is a well-defined chronic painful condition causing severe individual and societal burden. While mood disorders have been described, cognitive and behavioral profiles of SFN patients has not been investigated.
Thirty-four painful SFN patients underwent comprehensive cognitive, behavioral, psychological, quality of life (QoL), and personality assessment using validated questionnaires. As control samples, we enrolled 36 patients with painful peripheral neuropathy (PPN) of mixed etiology and 30 healthy controls (HC). Clinical measures of neuropathic pain, duration, frequency, and intensity of pain at the time of assessment were recorded. Between-group and correlation analyses were performed and corrected for multiple comparisons.
No differences in clinical measures were found between SFN and PPN, and all groups had similar cognitive profiles. SFN patients showed higher levels of anxiety and alexithymia (p < .005) compared to PPN and HC, considering also pain intensity. Maladaptive coping strategies characterized both patient groups, but only SFN revealed higher levels of acceptance of pain (p < .05). Pain intensity and neuropathic symptoms were associated with mood, low QoL and catastrophism (p < .001), particularly, the higher the perceived pain intensity, the higher the use of maladaptive coping strategies (p < .001). The personality assessment revealed significant feelings of worthlessness and somatization traits both in SFN and PPN (p < .002 vs HC).
our results suggest that SFN patients had a normal-like cognitive profile, while their behavioral profile is characterized by mood disorders, alexithymia, maladaptive coping strategies, and poor QoL, as other chronic pain conditions, possibly related to pain intensity. Personality assessment suggests that somatization and feelings of worthlessness, which may worsen the neuropsychological profile, deserve clinical attention when considering patients\' therapeutic approaches. At the same time, the high level of acceptance of pain is promising for therapeutic approaches based on psychological support.