The Central Sensitization Inventory validated and adapted for a Brazilian population: psychometric properties and its relationship with brain-derived neurotrophic factor

Abstract

ObjectivesThe primary aim was to assess the psychometric properties (including internal consistency, construct validity, reproducibility, and factor structure) of the Central Sensitization Inventory (CSI), adapted and validated for a Brazilian population (CSI-BP). Additionally, we evaluated the relationship between the CSI-BP and the serum brain-derived neurotrophic factor (BDNF) and determined if the symptoms elicited by the CSI-BP discriminate between subjects who do/do not respond to the conditioned pain modulation (CPM) task, as assessed by change in numeric pain scale (0–10) score.Patients and methodsA cross-sectional study was conducted in a pain clinic in a tertiary teaching hospital. A total of 222 adults with chronic musculoskeletal pain and 63 healthy control subjects completed the CSI-BP and the Brazilian Portuguese pain-catastrophizing scale (BP-PCS). A team of experts translated the CSI according to the international guidelines. Test–retest, item analysis, convergent validity, and factor analysis were performed. Later, a random subsample (n=77) was used to correlate the CSI-BP adjusted index with change in numeric pain-scale score during the CPM task and a BDNF blood sample.ResultsThe CSI-BP presented strong psychometric properties (test–retest reliability 0.91, Cronbach’s α=0.91). Confirmatory factor analysis yielded a four-factor structure, supporting the original English version. The CSI-BP adjusted index showed moderate positive correlation with the BP-PCS, and classified more than 80% of patients correctly vs healthy controls. Serum BDNF levels explained 27% of the variation in the CSI-BP adjusted index. Subjects with impairment in the descending modulatory system had higher CSI-BP adjusted index scores than subjects who responded normally to the CPM task: 49.35 (12.1) vs 39.5 (12.33), respectively (P<0.05).ConclusionThe CSI-BP was found to be a psychometrically strong and reliable instrument, with primary evidence of validity. Higher scores on the CSI-BP were correlated positively with serum BDNF and with greater dysfunction of the descending pain-modulatory system.

Cross‐cultural Adaptation and Psychometric Properties of the Greek Version of the Central Sensitization Inventory

“…Previous studies have found satisfactory test‐retest reliability (intraclass correlation coefficient [ICC] = 0.88 to 0.97) and internal consistency (Cronbach’s alpha = 0.88 to 0.91) . Although the CSI does not actually measure CS, CSI scores have been found to be associated with subjective and objective CS‐related variables, including lower pain thresholds, wider distribution of pain, longer pain duration, levels of brain‐derived neurotrophic factor, and dysfunction of the descending pain‐modulatory system . Also, total CSI scores have been found to discriminate between subjects with presumably different levels of CS, including patients with chronic regional pain, widespread pain/FM, and controls .…”

“…20,21,25,26 Also, total CSI scores have been found to discriminate between subjects with presumably different levels of CS, including patients with chronic regional pain, widespread pain/FM, and controls. 16,20,21 In a recent systematic review, researchers concluded that the CSI generates reliable and valid data to quantify the severity of CS-related symptoms. 27 A CSI score > 40 has been recommended as a reasonable cutoff score for alerting clinicians that further assessment for CS symptomology is warranted.…”

“…Part B comprises a list of CS‐related diagnoses. To date, translation, validation, and measurement properties of the CSI have been presented in multiple different languages (Table ), including Dutch, French, Spanish, Gujarati, Brazilian Portuguese, Serbian, Japanese, and Italian . CSI translations can be found at https://www.pridedallas.com/questionnaires/.…”

“…Although the CSI does not actually measure CS, CSI scores have been found to be associated with subjective and objective CS‐related variables, including lower pain thresholds, wider distribution of pain, longer pain duration, levels of brain‐derived neurotrophic factor, and dysfunction of the descending pain‐modulatory system . Also, total CSI scores have been found to discriminate between subjects with presumably different levels of CS, including patients with chronic regional pain, widespread pain/FM, and controls . In a recent systematic review, researchers concluded that the CSI generates reliable and valid data to quantify the severity of CS‐related symptoms …”

Cross‐Cultural Adaptation and Psychometric Validation of the Serbian Version of the Central Sensitization Inventory

“…Higher CSI scores have been associated with a wider body area distribution of self‐reported pain in a group of osteoarthritis patients scheduled to undergo primary total knee arthroplasty and increased widespread pain sensitivity in shoulder patients undergoing quantitative sensory testing . In addition, CSI scores have been found to correlate with other objective biological markers of CS, including brain gamma‐aminobutyric acid levels in migraine subjects and serum brain‐derived neurotrophic factor in fibromyalgia, myofascial pain, and osteoarthritis knee patients, compared to pain‐free control subjects …”