Publication: Comparison of cutaneous silent period parameters in patients with primary sjogren's syndrome with the healthy population
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Date
2022-06-01
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Abstract
Background: Neurological involvement has a great importance in the clinical
spectrum of primary Sjögren’s syndrome (pSS) (1). The presence of small fiber
neuropathy (SFN), which cannot be detected in routine electrophysiological
examinations, causes the peripheral nervous system involvement to be underestimated in the course of the disease and causes pain-related symptoms in
patients that cannot be explained by routine examinations (2). Various methods
can be used in the detection of SFN, and cutaneous silent period (CSP) measurement is gaining popularity recently due to its non-invasiveness and practical
application (3).
Objectives: Evaluating SFN involvement in patients with pSS using CSP and
evaluating its relationship with clinical parameters.
Methods: Patients with a diagnosis of pSS followed in the rheumatology outpatient
clinic and healthy volunteers demographically homogeneous with the patient group
were included in the study. The CSP responses were recorded over the abductor
pollicis brevis muscle in the upper extremity of all participants. The latency and duration values of the responses were obtained. In patient group, EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Hospital Anxiety and Depression Scale
(HADS), Short Form-36 (SF-36) questionnaire, Leeds Assessment of Neuropathic
Symptoms and Signs (LANSS) and Central Sensitization Inventory (CSI) were
applied for the evaluation of symptom severity, mood, quality of life, presence of neuropathic pain and central sensitization, respectively. Comparison of CSP parameters
between patients with pSS and healthy volunteers was determined as the primary
outcome measure. The secondary outcome measure was the relationship between
CSP parameters and ESSPRI, HADS, SF-36, LANSS and CSI scores.
Results: A total of 36 patients and 36 healthy controls were included in the final
analyses. There was no significant difference between the two groups in terms
of demographic data. The mean CSP latency was significantly longer in patients
with a mean of 78.18 (±7.51) when compared to controls with a mean of 67.91
(±6.41) (95% CI: 6.98- 13.55, p<0.001). Mean CSP duration was also significantly shorter in patients with a mean of 33.40 (±6.93) (95% CI: 9.57 -15.31,
p<0.001). There were no significant differences in CSP parameters (latency and
duration, respectively) according to patients’ neuropathic pain or central sensitization profile (p>0.05 for all analyses). There were significant correlations of CSP
parameters with ESSPRI dryness (r=0.469, p=0.004; r=-0.553, p<0.001), fatigue
(r=0.42, p=0.011; r=-0.505, p=0.002), pain (r=0.428, p=0.009; r=-0.57, p<0.001)
subscores and mean ESSPRI score (r=0.631, p<0.001; r=-0.749, p<0.001). Significant correlations were not found between CSP parameters and SF-36 scores,
other than CSP duration and “pain” subscore (r=-0.395, p=0.017). When the other
correlations were investigated there were no significant correlations other than
CSP duration and the HADS anxiety score (r=-0.201, p=0.02).
Conclusion: As an indicator of CSP measurement, SFN is more common in
patients with pSS than in the healthy population. The association with important
clinical symptoms of the disease course such as dryness, fatigue, pain and anxiety highlights the importance of detecting small fiber neuropathy
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Keywords
Tıp, Dahili Tıp Bilimleri, İç Hastalıkları, İmmünoloji ve Romatoloji, Sağlık Bilimleri, Medicine, Internal Medicine Sciences, Internal Diseases, Immunology and Rheumatology, Health Sciences, ROMATOLOJİ, Klinik Tıp, Klinik Tıp (MED), RHEUMATOLOGY, CLINICAL MEDICINE, Clinical Medicine (MED), Romatoloji, Rheumatology
Citation
Yolcu G., Abacar K., Kenis-Coskun O., Inanc N., Karadag-Saygi E., Gunduz O. H. , "COMPARISON OF CUTANEOUS SILENT PERIOD PARAMETERS IN PATIENTS WITH PRIMARY SJOGREN'S SYNDROME WITH THE HEALTHY POPULATION", ANNALS OF THE RHEUMATIC DISEASES, cilt.81, ss.1373-1374, 2022