Background:Back pain is one of the most common health complaints among university students. A subset of people suffering from chronic back pain exhibit features of increased pain sensitivity and altered pain processing, suggesting central sensitization (CS) to pain1. The mechanisms behind these processes are, to date, not fully understood2. Evidence shows that in chronic pain, cognitive factors could contribute to the occurrence of central pain sensitization3,4.Objectives:To assess the association between CS and features of adult Attention Deficit Hyperactivity Disorder (ADHD) in medical students suffering from chronic back pain.Methods:Data was collected from medical students during the academic year 2018-2019 at Suez Canal University using an online survey. The survey included a section on self-reported musculoskeletal pain including back pain lasting more than 3 months in the neck, upper back and lower back, part (A) of the central sensitization inventory (CSI) and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v 1.1). Associations between CSI and ASRS-v 1.1 in students with back pain was assessed using Spearman’s correlation. Linear regression was used to estimate cross-sectional associations adjusted for age and gender.Results:Two hundred and thirty students completed the survey, 93 (40.4%) had back pain for more than 3 months. Students with back pain had significantly higher CS and attention deficit according to CSI (P<0.01), and the ASRS-v 1.1 scores (P=0.09). Correlation results showed a strong positive association between CS and ADHD in students with back pain (correlation coefficient = 0.41, P<0.001). This association remained significant after adjusting for age and gender (P<0.001).Conclusion:Results of this study suggest that in students suffering from chronic back pain, features of attention deficit are associated with elevated CS. The direction of the association requires further study and may provide novel insights into the interaction between CS and cognitive factors.References:[1]Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, Clauw DJ. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 2004 Feb;50(2):613-23.[3]Coppieters I, Ickmans K, Cagnie B, Nijs J, De Pauw R, Noten S, Meeus M. Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia. Pain physician. 2015;18(3):E389-401.[4]Roussel NA, Nijs J, Meeus M, Mylius V, Fayt C, Oostendorp R. Central sensitization and altered central pain processing in chronic low back pain: fact or myth?. The Clinical journal of pain. 2013 Jul 1;29(7):625-38.Disclosure of Interests: :None declared
Linking altered central pain processing and genetic polymorphism to drug efficacy in chronic low back pain