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Kotova O.A.*, Teslova O.A.**, Kubrakov K.M.***
The peculiarities of pain sensation in patients with vertebrospinal injury sequelae
*Establishment "Gomel Regional Clinical Hospital for the Disabled Patriotic War Veterans", Republic of Belarus
**Education Establishment "Gomel State Medical University", Republic of Belarus
***Education Establishment "Vitebsk State Order of Peoples’ Friendship Medical University", Republic of Belarus

Abstract.
Objectives. To study the peculiarities of psychoemotional reactions in the sensation of pain in patients who have sustained spinal injury.
Material and methods. The study included 130 persons. The main group (1) consisted of 80 able-bodied patients  who had sustained spinal cord injury at the age of 30 [25-37] years. The comparison group (2) was composed of 50 people without spinal injury, selected at random from the population. Age and sex structure of the control sample corresponded to that of the main group.
Pain sensations were assessed by means of visual analog scale of pain (VAS), and neuropathic pains questionnaire DN4. For anxiety and depression level diagnosis Taylor anxiety test and Montgomery-Aisberg depression scale (MADRS) were used. Statistical processing of data was performed with the help of software package «Statistica 6,1» (StatSoft, Tulsa, USA).
Results. After  analyzing the clinical characteristics of patients with spinal injury we found no correlations between the sensation of pain and neuropathic character of  pains and the remoteness of injury, its vertebral level and the degree of neurological disorders. Only in case of injuries, localized in the cervical part of the spine, there was a lower neuropathic pains threshold (H=6,92, p=0,031). Statistically significant differences of patients of the 1st and the 2nd groups according to VAS (Z=5,51, p<0,00001) and DN4 (Z=5,37, p<0,00001) and a strong positive association between DN4 and VAS (r=0,5663, p=0,000000002) were found. The association of both anxiety (Rs=0,22, p<0,02) and depression (Rs=0,32, p<0,0005) with pain sensations was determined. Neuropathic pains intensify the existing manifestations of depressive reactions (Rs=0,32, p<0,0004).
Conclusion. Patients who have had spinal injuries, experience constant pain syndrome and neuropathic pains, the presence of which affects their emotional state. The appearance of anxiety and depressive reactions accompanying pain is observed. In addition, neuropathic pains intensify the existing depressive symptoms.
Key words: spinal cord injury, neuropathic pain, anxiety, depression.

References

1. Merskey H. Classification of chronic pain: description of chronic pain syndromes and definitions of pain terms [Electronic resource]ttSeatlle: IASP Press; 1994. Mode of access: http://www.iasp-pain.org/files/Content/ContentFolders/Publications2/FreeBooks/Classification-of-Chronic-Pain.pdf. Data of access: 30.07.2012.
2. Cardenas D, Jensen M. Treatments for chronic pain in persons with spinal cord injury: a survey study. J Spinal Cord Med. 2006; 29(2):109-17.
3. Jensen MP, Moore MR, Bockow TB, BA, Ehde DM, Engel JM. Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. Arch Phys Med Rehabil. 2011 Jan; 92(1):146-60.
4. Heutink M, Post MWM, Luthart P, Pfennings LE, Dijkstra CA, Lindeman E. A multidisciplinary cognitive behavioural programme for coping with chronic neuropathic pain following spinal cord injury: the protocol of the CONECSI trial [Electronic resource]. BMC Neurology. 2010. Mode of access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984384/. Data of access: 30.07.2012.
5. Raichle KA, Hanley M, Jensen MP, Cardenas DD. Cognitions, Coping and Social Environment Predict Adjustment to Pain in Spinal Cord Injury. J Pain. 2007 Sep;8(9):718-29.
6. Baikova IA. Bol'. Metody terapii boli [Pain. Methods of therapy of pain]: ucheb.-metod. posobie. Minsk, RB: BelMAPO; 2004. 24 р.
7. Sviatogor MV, Kasimova LN. Rasprostranennost' i klinicheskaia kharakteristika psikhogennykh bolevykh rasstroistv [Prevalence and clinical characteristic of psychogenic painful disorders]. V: Klinicheskie i teoreticheskie aspekty ostroi i khronicheskoi boli: tez. dokl. Ros. nauch.-prakt. konf. s mezhdunar. uchastiem. Nizhny Novgorod, RF; 2003. p. 44c46.
8. Melkumova KA, Podchufarova EV, Iakhno NN. Osobennosti kognitivnykh funktsii u patsientov s khronicheskoi bol'iu v spine [Features of cognitive functions at patients with a chronic dorsodynia]. Zhurnal nevrologii i psikhiatrii im. S. S. Korsakova. 2009;109(11):20-4.
9. Huskisson EC. Measurement of pain. Lancet. 1974;304(7889):1127-231.
10. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, Lantéri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005 Mar;114(1-2):29-36.
11. Taylor JA. A personality scale of manifest anxiety [Electronic resource]. Journal of Abnormal & Social Psychology. 1953;48(2). Mode of access: http://journals.ohiolink.edu/ejc/article.cgi?issn=0096851x&issue=v48i0002&article=285_apsoma. Data of access: 22.11.12.
12. Montgomery SA, Asberg M. А new depression scale designed to be sensitive to change. Br J Psychiatry. 1979 Apr;134:382-9.

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