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Convergent validity of the Dutch Central Sensitization Inventory : associations with psychophysical pain measures, quality of life, disability, and pain cognitions in patients with chronic spinal pain

Jeroen Kregel (UGent) , Charline Schumacher (UGent) , Mieke Dolphens (UGent) , Anneleen Malfliet (UGent) , Dorien Goubert (UGent) , Dorine Lenoir (UGent) , Barbara Cagnie (UGent) , Mira Meeus (UGent) and Iris Coppieters (UGent)
(2018) PAIN PRACTICE. 18(6). p.777-787
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Abstract
Objective: Symptoms of central sensitization (CS) have been described in patients with chronic spinal pain (CSP). Although a gold standard to diagnose CS is lacking, psychophysical pain measures are often used. The Central Sensitization Inventory (CSI) is proposed as an alternative method and indirect tool for the evaluation of CS symptomatology. The aim of the current study was to evaluate the convergent validity of the CSI by investigating the association with psychophysical pain measures and self-reported measures of current pain intensity, quality of life, disability, and catastrophizing in CSP patients. Methods: One hundred sixteen patients with nonspecific CSP were included in the present study. Patients completed the CSI, were subjected to pressure pain thresholds (PPTs) and a conditioned pain modulation (CPM) paradigm, and completed questionnaires for current pain intensity, quality of life, pain disability, and pain catastrophizing. Results: Higher CSI scores were weakly correlated with lower PPTs (-0.276r-0.237; all P0.01) and not with CPM efficacy (r=0.017; P=0.858). Higher CSI scores were moderately correlated with higher current pain intensity (r=0.320; P<0.001), strongly correlated with lower physical (r=-0.617; P<0.001) and emotional (r=-0.635; P<0.001) quality of life, and moderately correlated with higher pain disability (r=0.472; P<0.001) and higher pain catastrophizing (r=0.464; P<0.001). Conclusion: The CSI was weakly associated with PPTs and not with CPM efficacy in CSP patients. Moderate to strong associations were found with current pain intensity, quality of life, disability, and catastrophizing. The current results illustrate that the CSI does not reflect a direct measure of CS, yet is a representation of general distress, possible originating from CS symptoms.
Keywords
central sensitization, Central Sensitization Inventory, pressure pain threshold, conditioned pain modulation, chronic low back pain, chronic neck pain, LOW-BACK-PAIN, CHRONIC-FATIGUE-SYNDROME, MECHANISMS-BASED CLASSIFICATIONS, CENTRAL SENSITIVITY SYNDROMES, NOXIOUS INHIBITORY CONTROL, NECK PAIN, MUSCULOSKELETAL PAIN, TEMPORAL SUMMATION, CHRONIC WHIPLASH, HEALTH SURVEY

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Chicago
Kregel, Jeroen, Charline Schumacher, Mieke Dolphens, Anneleen Malfliet, Dorien Goubert, Dorine Lenoir, Barbara Cagnie, Mira Meeus, and Iris Coppieters. 2018. “Convergent Validity of the Dutch Central Sensitization Inventory : Associations with Psychophysical Pain Measures, Quality of Life, Disability, and Pain Cognitions in Patients with Chronic Spinal Pain.” Pain Practice 18 (6): 777–787.
APA
Kregel, J., Schumacher, C., Dolphens, M., Malfliet, A., Goubert, D., Lenoir, D., Cagnie, B., et al. (2018). Convergent validity of the Dutch Central Sensitization Inventory : associations with psychophysical pain measures, quality of life, disability, and pain cognitions in patients with chronic spinal pain. PAIN PRACTICE, 18(6), 777–787.
Vancouver
1.
Kregel J, Schumacher C, Dolphens M, Malfliet A, Goubert D, Lenoir D, et al. Convergent validity of the Dutch Central Sensitization Inventory : associations with psychophysical pain measures, quality of life, disability, and pain cognitions in patients with chronic spinal pain. PAIN PRACTICE. 2018;18(6):777–87.
MLA
Kregel, Jeroen, Charline Schumacher, Mieke Dolphens, et al. “Convergent Validity of the Dutch Central Sensitization Inventory : Associations with Psychophysical Pain Measures, Quality of Life, Disability, and Pain Cognitions in Patients with Chronic Spinal Pain.” PAIN PRACTICE 18.6 (2018): 777–787. Print.
@article{8544898,
  abstract     = {Objective: Symptoms of central sensitization (CS) have been described in patients with chronic spinal pain (CSP). Although a gold standard to diagnose CS is lacking, psychophysical pain measures are often used. The Central Sensitization Inventory (CSI) is proposed as an alternative method and indirect tool for the evaluation of CS symptomatology. The aim of the current study was to evaluate the convergent validity of the CSI by investigating the association with psychophysical pain measures and self-reported measures of current pain intensity, quality of life, disability, and catastrophizing in CSP patients. 
Methods: One hundred sixteen patients with nonspecific CSP were included in the present study. Patients completed the CSI, were subjected to pressure pain thresholds (PPTs) and a conditioned pain modulation (CPM) paradigm, and completed questionnaires for current pain intensity, quality of life, pain disability, and pain catastrophizing. 
Results: Higher CSI scores were weakly correlated with lower PPTs (-0.276r-0.237; all P0.01) and not with CPM efficacy (r=0.017; P=0.858). Higher CSI scores were moderately correlated with higher current pain intensity (r=0.320; P{\textlangle}0.001), strongly correlated with lower physical (r=-0.617; P{\textlangle}0.001) and emotional (r=-0.635; P{\textlangle}0.001) quality of life, and moderately correlated with higher pain disability (r=0.472; P{\textlangle}0.001) and higher pain catastrophizing (r=0.464; P{\textlangle}0.001). 
Conclusion: The CSI was weakly associated with PPTs and not with CPM efficacy in CSP patients. Moderate to strong associations were found with current pain intensity, quality of life, disability, and catastrophizing. The current results illustrate that the CSI does not reflect a direct measure of CS, yet is a representation of general distress, possible originating from CS symptoms.},
  author       = {Kregel, Jeroen and Schumacher, Charline and Dolphens, Mieke and Malfliet, Anneleen and Goubert, Dorien and Lenoir, Dorine and Cagnie, Barbara and Meeus, Mira and Coppieters, Iris},
  issn         = {1530-7085},
  journal      = {PAIN PRACTICE},
  keyword      = {central sensitization,Central Sensitization Inventory,pressure pain threshold,conditioned pain modulation,chronic low back pain,chronic neck pain,LOW-BACK-PAIN,CHRONIC-FATIGUE-SYNDROME,MECHANISMS-BASED CLASSIFICATIONS,CENTRAL SENSITIVITY SYNDROMES,NOXIOUS INHIBITORY CONTROL,NECK PAIN,MUSCULOSKELETAL PAIN,TEMPORAL SUMMATION,CHRONIC WHIPLASH,HEALTH SURVEY},
  language     = {eng},
  number       = {6},
  pages        = {777--787},
  title        = {Convergent validity of the Dutch Central Sensitization Inventory : associations with psychophysical pain measures, quality of life, disability, and pain cognitions in patients with chronic spinal pain},
  url          = {http://dx.doi.org/10.1111/papr.12672},
  volume       = {18},
  year         = {2018},
}

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