Prevalence of Central Sensitization in Notalgia Paresthetica Patients and its Association with Vertebral Degeneration: A Cross-sectional Study

Abstract

Notalgia paresthetica (NP) is a sensory neuropathy characterized by itching and hyperpigmentation, typically around the scapular region. This study aimed to investigate the relationships between clinical findings, radiological features, and central sensitization (CS) in NP patients. This cross-sectional study included 45 NP patients and 45 age- and gender-matched healthy controls. Neuropathic symptoms were assessed using the painDETECT questionnaire (PD-Q), while CS symptoms were evaluated with the Central Sensitization Inventory (CSI). Pain and pruritus severity were evaluated using a Visual Analogue Scale (VAS). Cervical–thoracic vertebral pathologies were examined via 2-view X-rays. Vertebral degeneration was observed in 75.5% of NP patients, which was significantly higher than in controls (p = 0.001). CS was present in 48.9% of NP patients, also significantly higher than in the control group (p = 0.020). A higher rate of prior fibromyalgia diagnosis, based on CSI-B responses, was found in NP patients (p = 0.05). NP patients with CS had significantly higher VAS pain scores (p < 0.001), PD-Q scores (p = 0.005), and vertebral degeneration rates (p = 0.001) compared with those without CS. Additionally, 63.6% of NP patients with CS had lesions in multiple vertebral regions (p = 0.002). CS is common in NP patients, especially in those with vertebral degeneration. Multidisciplinary evaluation considering CS status may improve management of NP.