Evaluating Sensitization-Associated, Neuropathic-Like Symptoms and Psychological Factors in Patients with Interstitial Lung Disease

The aims of this study were to phenotype pain in patients with interstitial lung disease (ILD) by investigating the association between sensitization-associated symptoms with quality of life, anxiety/depression, pain catastrophizing and kinesiophobia levels, and, identifying those risk factors explaining the variance of quality of life in individuals with ILD and pain. One hundred and thirty-two (38.6% women, mean age: 70, SD: 10.5 years) patients with ILD completed clinical (age, sex, height, weight), psychological (Hospital Anxiety and Depression Scale, HADS and the Pittsburgh Sleep Quality Index, PSQI), and health-related quality of life (EQ-5D-5L) variables as well as the Central Sensitization Inventory (CSI), the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-11) questionnaires. The prevalence of sensitization-associated symptomatology (CSI), neuropathic-like features (S-LANSS), anxiety symptoms, depressive symptoms or poor sleep was 20.5%, 23.5%, 23.6%, 22.9% or 51.6%. Significant associations between CSI, S-LANSS, HADS-A, HADS-D, PCS, TSK-11 and EQ-5D-5L (.220<r<.716) were found. The regression analysis revealed that CSI, TSK-11 and HADS-D explained 44.8% of the variance of EQ-5D-5L (r2 adjusted:.448). This study found that the presence of sensitization-associated and neuropathic-like symptoms as well as other central nervous system-derived symptoms, such as anxiety, depression, poor sleep, pain catastrophizing and kinesiophobia in 25% of ILD patients with pain. Sensitization-associated symptoms, depression and kinesiophobia were associated with worse quality of life. These findings would support that individuals with ILD can exhibit different pain phenotypes, including nociplastic like pain phenotype, based on self-reported measurements. PERSPECTIVE: Pain in patients with interstitial lung disease can fulfill features of different phenotypes, including nociplastic pain, when sensory, emotional and cognitive mechanisms are involved at the same time.