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Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome

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Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome

dc.contributor.author	Pellicer Valero, Oscar José
dc.contributor.author	Martín Guerrero, José David
dc.contributor.author	Fernández de las Peñas, César
dc.contributor.author	Llave Rincón, Ana Isabel de la
dc.contributor.author	Rodríguez Jiménez, Jorge
dc.contributor.author	Navarro Pardo, Esperanza
dc.contributor.author	Cigarán Méndez, Margarita I.
dc.date.accessioned	2021-09-24T07:43:00Z
dc.date.available	2021-09-24T07:43:00Z
dc.date.issued	2021
dc.identifier.citation	Pellicer Valero, Oscar José Martín Guerrero, José David Fernández de las Peñas, César Llave Rincón, Ana Isabel de la Rodríguez Jiménez, Jorge Navarro Pardo, Esperanza Cigarán Méndez, Margarita I. 2021 Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome Symmetry-Basel 13 6 1042
dc.identifier.uri	https://hdl.handle.net/10550/80357
dc.description.abstract	Identification of subgroups of patients with chronic pain provides meaningful insights into the characteristics of a specific population, helping to identify individuals at risk of chronification and to determine appropriate therapeutic strategies. This paper proposes the use of spectral clustering (SC) to distinguish subgroups (clusters) of individuals with carpal tunnel syndrome (CTS), making use of the obtained patient profiling to argue about potential management implications. SC is a powerful algorithm that builds a similarity graph among the data points (the patients), and tries to find the subsets of points that are strongly connected among themselves, but weakly connected to others. It was chosen due to its advantages with respect to other simpler clustering techniques, such as k-means, and the fact that it has been successfully applied to similar problems. Clinical (age, duration of symptoms, pain intensity, function, and symptom severity), psycho-physical (pressure pain thresholds¿PPTs¿over the three main nerve trunks of the upper extremity, cervical spine, carpal tunnel, and tibialis anterior), psychological (depressive levels), and motor (pinch tip grip force) variables were collected in 208 women with clinical/electromyographic diagnosis of CTS, whose symptoms usually started unilaterally but eventually evolved into bilateral symmetry. SC was used to identify clusters of patients without any previous assumptions, yielding three clusters. Patients in cluster 1 exhibited worse clinical features, higher widespread pressure pain hyperalgesia, higher depressive levels, and lower pinch tip grip force than the other two. Patients in cluster 2 showed higher generalized thermal pain hyperalgesia than the other two. Cluster 0 showed less hypersensitivity to pressure and thermal pain, less severe clinical features, and more normal motor output (tip grip force). The presence of subgroups of individuals with different altered nociceptive processing (one group being more sensitive to pressure pain and another group more sensitive to thermal pain) could lead to different therapeutic programs.
dc.language.iso	eng
dc.relation.ispartof	Symmetry-Basel, 2021, vol. 13, num. 6 , p. 1042
dc.subject	Dones Malalties
dc.title	Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome
dc.type	journal article	es_ES
dc.date.updated	2021-09-24T07:43:01Z
dc.identifier.doi	10.3390/sym13061042
dc.identifier.idgrec	147304
dc.rights.accessRights	open access	es_ES