Convergent Validity of the Central Sensitization Inventory in Chronic Whiplash-Associated Disorders; Associations with Quantitative Sensory Testing, Pain Intensity, Fatigue, and Psychosocial Factors

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3401-3412
Author(s):  
Erwin Hendriks ◽  
Lennard Voogt ◽  
Dorine Lenoir ◽  
Iris Coppieters ◽  
Kelly Ickmans
Keyword(s):  
Psychosocial Factors ◽  
Central Sensitization ◽  
Convergent Validity ◽  
Quantitative Sensory Testing ◽  
Temporal Summation ◽  
Sensory Testing ◽  
Pressure Pain Thresholds ◽  
Central Sensitization Inventory ◽  
Whiplash Associated Disorders ◽  
Chronic Whiplash

Abstract Objective Central sensitization is present in different pain conditions, including chronic whiplash-associated disorders. In the absence of a gold standard method of assessment to determine the presence of central sensitization, quantitative sensory testing is currently understood as an optimal proxy. Laboratory sensory testing is, however, not feasible in clinical practice, and the Central Sensitization Inventory was developed as an alternative. The aim of the current study was to evaluate the convergent validity of the Central Sensitization Inventory in chronic whiplash-associated patients by determining the association between the Central Sensitization Inventory and quantitative sensory testing, pain intensity, fatigue, and psychosocial factors. Methods A total of 125 chronic whiplash-associated patients completed multiple questionnaires and were subjected to pressure pain thresholds and temporal summation. Results . The Central Sensitization Inventory showed a strong association with constructs of general psychopathology, anxiety, distress, depression, and somatization in chronic whiplash-associated disorders. Moderate correlations were found with fatigue and intrusive and avoidant phenomena after a variety of traumatic events. No significant association was found between the Central Sensitization Inventory and pressure pain thresholds and temporal summation, nor between the Central Sensitization Inventory and other pain measurements. Conclusions Overall, we found that the Central Sensitization Inventory is better in identifying the psychosocial factors related to central sensitization in chronic whiplash-associated disorders than the central nervous system adaptations. Thus, the convergent validity of the Central Sensitization Inventory appears to be only partially present in chronic whiplash-associated disorders.

scholarly journals Expanded Distribution of Pain as a Sign of Central Sensitization in Individuals With Symptomatic Knee Osteoarthritis

2016 ◽  
Vol 96 (8) ◽  
pp. 1196-1207 ◽  
Author(s):  
Enrique Lluch Girbés ◽  
Lirios Dueñas ◽  
Marco Barbero ◽  
Deborah Falla ◽  
Isabel A.C. Baert ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Central Sensitization ◽  
Quantitative Sensory Testing ◽  
Clinical Symptoms ◽  
Sensory Testing ◽  
Knee Oa ◽  
Pressure Pain Thresholds ◽  
Symptomatic Knee Osteoarthritis ◽  
Pain Frequency ◽  
Pain Drawings

AbstractBackgroundExpanded distribution of pain is considered a sign of central sensitization (CS). The relationship between recording of symptoms and CS in people with knee osteoarthritis (OA) has been poorly investigated.ObjectiveThe aim of this study was to examine whether the area of pain assessed using pain drawings relates to CS and clinical symptoms in people with knee OA.DesignThis was a cross-sectional study.MethodsFifty-three people with knee OA scheduled to undergo primary total knee arthroplasty were studied. All participants completed pain drawings using a novel digital device, completed self-administration questionnaires, and were assessed by quantitative sensory testing. Pain frequency maps were generated separately for women and men. Spearman correlation coefficients were computed to reveal possible correlations between the area of pain and quantitative sensory testing and clinical symptoms.ResultsPain frequency maps revealed enlarged areas of pain, especially in women. Enlarged areas of pain were associated with higher knee pain severity (rs=.325, P<.05) and stiffness (rs=.341, P<.05), lower pressure pain thresholds at the knee (rs=−.306, P<.05) and epicondyle (rs=−.308, P<.05), and higher scores with the Central Sensitization Inventory (rs=.456, P<.01). No significant associations were observed between the area of pain and the remaining clinical symptoms and measures of CS.LimitationsFirm conclusions about the predictive role of pain drawings cannot be drawn. Further evaluation of the reliability and validity of pain area extracted from pain drawings in people with knee OA is needed.ConclusionExpanded distribution of pain was correlated with some measures of CS in individuals with knee OA. Pain drawings may constitute an easy way for the early identification of CS in people with knee OA, but further research is needed.

scholarly journals Central Sensıtızatıon ın Axıal Spondyloarthrıtıs: An Exploratıve Study wıth Quantıtatıve Sensory Testıng and Clınıcal Scales

2021 ◽  
Author(s):  
Feyza Nur Yücel ◽  
Mehmet Tuncay Duruöz
Keyword(s):  
Central Sensitization ◽  
Quantitative Sensory Testing ◽  
Axial Spondyloarthritis ◽  
Pressure Pain Threshold ◽  
Female Gender ◽  
Pain Modulation ◽  
Sensory Testing ◽  
Clinical Scales ◽  
Significant Difference ◽  
And Control

ABSTRACT Objective To evaluate the central sensitization (CS) and the related parameters in patients with axial spondyloarthritis (axSpA). Methods Quantitative sensory testing (QST) which consists of pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM) were applied to the participants. Disease activity, functional status, sleep quality, pain, depression, and fatigue were assessed. Patients were divided as the ones with and without CS according to the central sensitization inventory (CSI) and the results were compared. Results One hundred patients and fifty controls were recruited. Sixty axSpA patients had CS. When QST results were compared between the patient and control groups, all PPT scores were found lower (p<0.05) in patients. Regarding the comparison of the patients with and without CS, sacroiliac, and trapezius PPT scores were found lower in the patients with CS (p<0.05). On the other hand, there was no significant difference in the mean TS scores (p>0.05) between patients and controls, and in patients with and without CS. All investigated comorbidities were found to be significantly more frequent (p<0.001) in the patients with CS. In regression analysis female gender, morning stiffness duration, CPM, depression, and fatigue were detected as related parameters with CSI scores. Conclusion CS and related comorbidities were found to be increased in axSpA patients. This increase should be taken into consideration in the management of these patients.

Development of a novel brief quantitative sensory testing protocol that integrates static and dynamic pain assessments: Test-retest performance in healthy adults

Pain Medicine ◽  
2021 ◽  
Author(s):  
Martin J De Vita ◽  
Katherine Buckheit ◽  
Christina E Gilmour ◽  
Dezarie Moskal ◽  
Stephen A Maisto
Keyword(s):  
Quantitative Sensory Testing ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Pain Modulation ◽  
Healthy Adults ◽  
Dynamic Responses ◽  
Conditioned Pain Modulation ◽  
Sensory Testing ◽  
Contact Heat ◽  
Intraclass Correlations

Abstract Objective Quantitative sensory testing is an expanding pain research domain with numerous clinical and research applications. There is a recognized need for brief reliable quantitative sensory testing protocols that enhance assessment feasibility. This study aimed to integrate static (pain threshold, tolerance, suprathreshold) and dynamic (conditioned pain modulation, offset analgesia, temporal summation) pain reactivity measures into a brief 20-minute protocol that uses a single portable device. The test-retest performance of this optimized protocol was evaluated. Design Using a test-retest design, the brief quantitative sensory testing assessment was administered to participants on two occasions separated by exactly 7 days. Setting A clinical psychology research laboratory at Syracuse University. Subjects Participants were 33 healthy adults recruited from Syracuse University’s online research participation pool. Methods A portable computerized quantitative sensory testing device delivered contact-heat pain to assess static and dynamic pain measures in participants. Dynamic responses were continuously recorded using a computerized visual analog scale. Results Pain threshold, tolerance, and suprathreshold exhibited excellent reliability (intraclass correlations ranged from 0.80 to 0.83). Conditioned pain modulation, offset analgesia, temporal summation yielded reliability in the good to excellent range (intraclass correlations ranged from 0.66 to 0.71). Conclusions Findings suggested that this brief integrated QST protocol may reliably monitor human pain reactivity over brief periods. This protocol may enhance quantitative sensory testing feasibility in clinical and research settings.

scholarly journals Discordance between pain and radiographic severity in knee osteoarthritis: Findings from quantitative sensory testing of central sensitization

2013 ◽  
Vol 65 (2) ◽  
pp. 363-372 ◽  
Author(s):  
Patrick H. Finan ◽  
Luis F. Buenaver ◽  
Sara C. Bounds ◽  
Shahid Hussain ◽  
Raymond J. Park ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Central Sensitization ◽  
Quantitative Sensory Testing ◽  
Sensory Testing ◽  
Radiographic Severity

scholarly journals Tests for central sensitization in general practice: a Delphi study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Carine den Boer ◽  
Berend Terluin ◽  
Johannes C. van der Wouden ◽  
Annette H. Blankenstein ◽  
Henriëtte E. van der Horst
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
General Practice ◽  
Delphi Study ◽  
Central Sensitization ◽  
Added Value ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Central Sensitization Inventory

Abstract Introduction Central sensitization (CS) may explain the persistence of symptoms in patients with chronic pain and persistent physical symptoms (PPS). There is a need for assessing CS in the consultation room. In a recently published systematic review, we made an inventory of tests for CS. In this study we aimed to assess which tests might have added value, might be feasible and thus be suitable for use in general practice. Methods We conducted a Delphi study consisting of two e-mail rounds to reach consensus among experts in chronic pain and PPS. We invited 40 national and international experts on chronic pain and PPS, 27 agreed to participate. We selected 12 tests from our systematic review and additional searches; panellists added three more tests in the first round. We asked the panellists, both clinicians and researchers, to rate these 15 tests on technical feasibility for use in general practice, added value and to provide an overall judgement for suitability in general practice. Results In two rounds the panellists reached consensus on 14 of the 15 tests: three were included, eleven excluded. Included were the Central Sensitization Inventory (CSI), pressure pain thresholds (PPTs) and monofilaments. No consensus was reached on the Sensory Hypersensitivity Scale. Conclusion In a Delphi study among an international panel of experts, three tests for measuring CS were considered to be suitable for use in general practice: the Central Sensitization Inventory (CSI), pressure pain thresholds (PPTs) and monofilaments.

“Convergent validity of the central sensitization inventory and experimental testing of pain sensitivity”

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Liam Andrén Holm ◽  
Casper Glissmann Nim ◽  
Henrik Hein Lauridsen ◽  
Johanne Brinch Filtenborg ◽  
Søren Francis O’Neill
Keyword(s):  
Roc Curve ◽  
Central Sensitization ◽  
Convergent Validity ◽  
Pain Sensitivity ◽  
Experimental Pain ◽  
Test Protocol ◽  
Social Constructs ◽  
Care Clinic ◽  
Central Sensitization Inventory ◽  
Pain Test

Abstract Objectives The aim of the current study was to examine the convergent validity of the Central Sensitization Inventory by quantifying the correlation with experimental measures of pain sensitivity and self-reported psycho-social questionnaires, in a low back pain population. Methods All participants were recruited from an outpatient hospital spine care clinic (Spine Centre of Southern Denmark). Participants underwent a standardized experimental pain test protocol and completed the Central Sensitization Inventory (CSI) along with additional self-reported questionnaires to assess psycho-social constructs across different domains. The association between the CSI, experimental pain measures and other self-reported psycho-social questionnaires were analyzed using correlation and contingency tests. ROC-curve analysis was used to determine sensitivity and specificity for CSI. Results One hundred sixty-eight (168) participants were included. The CSI was weakly correlated with nine out of 20 variables in the experimental pain test protocol (rho range −0.37 to 0.22). The CSI was more closely correlated with psycho-social factors such as work ability, disability, and symptoms of exhaustion disorder. ROC-analysis identified an optimal cut-point of 44 on CSI (Sn=39.1% Sp=87.4%). The CSI had an area under the ROC curve of 0.656. Fisher’s exact test demonstrated a statistically significant association between participants scoring ≥40 on CSI and participants categorized as sensitized by experimental pain tests (p-value=0.03). Conclusions Our findings are consistent with previous studies, indicating that the CSI is related to psycho-social constructs. However, the convergent validity with experimental pain measures is small and probably not clinically meaningful.

scholarly journals A pilot study investigating whether quantitative sensory testing alters after treatment in patients with fibromyalgia

2018 ◽  
Vol 12 (4) ◽  
pp. 250-256 ◽  
Author(s):  
Theresa Wodehouse ◽  
Kavita Poply ◽  
Shankar Ramaswamy ◽  
Saowarat Snidvongs ◽  
Julius Bourke ◽  
...  
Keyword(s):  
Pilot Study ◽  
Quantitative Sensory Testing ◽  
Fibromyalgia Impact Questionnaire ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Sensory Testing ◽  
Central Sensitisation ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Background: Fibromyalgia is a chronic musculoskeletal pain condition that is often associated with sleep disturbances and fatigue. The pathophysiology of fibromyalgia is not understood, but indirect evidence suggests a central dysfunction of the nociceptive modulating system. The aim of this study was to evaluate whether quantitative sensory testing detects a change in pain thresholds in fibromyalgia patient receiving pregabalin treatment. Methods: A total of 25 patients were recruited for the study and received routine pregabalin, but only 14 patients completed the treatment. Assessment of pressure pain thresholds and changes in conditioned pain modulation using ischaemic pain as a conditioning stimulus were measured at baseline and every 4 weeks for 12 weeks. Fibromyalgia impact questionnaire, PainDETECT and SF-12 were also completed. Results: Patients with fibromyalgia demonstrated a less-efficient conditioned pain modulation at baseline. An efficient conditioned pain modulation was observed at 1 month and this was maintained until the final visit. Pressure pain thresholds (PPTs) showed a significant improvement from baseline. Patients also reported a similar magnitude of improvements in PainDETECT, fibromyalgia impact questionnaire (FIQ) and its impact on daily life and change in outcome for SF-12. Conclusion: This pilot study reports an increase in PPTs and improved conditioned pain modulation response after commencing pregabalin, which was maintained at 12 weeks, and this was supported by positive pain scores. Pregabalin is a licenced treatment for fibromyalgia in Europe, and its response to central sensitisation, particularly ‘dynamic responses’, has not been reported. We conclude that pregabalin has the potential to reduce peripheral and central sensitisation in patients with fibromyalgia, as measured using quantitative sensory testing.

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