The Development and Psychometric Validation of the Central Sensitization Inventory

Abstract

Central Sensitization (CS) has been proposed as a common pathophysiological mechanism to explain related syndromes for which no specific organic cause can be found. The term Central Sensitivity Syndrome (CSS) has been proposed to describe these poorly understood disorders related to CS. The goal of this investigation was to develop the Central Sensitization Inventory (CSI), which identifies key symptoms associated with CSSs, and quantifies the degree of these symptoms. The utility of the CSI, to differentiate among different types of chronic pain patients that presumably have different levels of CS impairment, was then evaluated. Study 1 demonstrated strong psychometric properties (test-retest reliability = 0.817; Cronbach's alpha = 0.879) of the CSI in a cohort of normative subjects. A factor analysis (including both normative and chronic pain subjects) yielded 4 major factors (all related to somatic and emotional symptoms), accounting for 53.4% of the variance in the dataset. In Study 2, the CSI was administered to four groups: fibromyalgia (FM); chronic widespread pain (CWP) without FM; work-related regional chronic low back pain (CLBP); and normative control group. Analyses revealed that the FM patients reported the highest CSI scores, and the normative population the lowest (p<.05). Analyses also demonstrated that the prevalence of previously diagnosed CSSs and related disorders was highest in the FM group and lowest in the normative group (p<.001). Taken together, these two studies demonstrate the psychometric strength, clinical utility, and the initial construct validity of the CSI in evaluating CS-related clinical symptoms in chronic pain populations.

Pain following cancer treatment: Guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain

“…A second option is the Central Sensitization Inventory (CSI) [42], which assesses symptoms common to central sensitization [43]. Several studies support the clinimetric properties of the CSI [42,43]. The cutoff of 40 on the CSI allows correct identification of over 82% of central sensitization pain patients, but the chances of false-positives are relatively high, which supports our approach of combining this measure with a more comprehensive examination for identification of predominant central sensitization pain in cancer survivors.…”

“…Recent studies demonstrate that pain ratings on application of ice correlate well with quantitative measures of cold pain thresholds and may be a valuable clinical tool [40,41]. A second option is the Central Sensitization Inventory (CSI) [42], which assesses symptoms common to central sensitization [43]. Several studies support the clinimetric properties of the CSI [42,43].…”

Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education

“…This includes hypersensitivity to light, sounds, smell, taste, and a hypersensitive skin. The CSI appears to be a valid, reliable, usable, and diagnostically relevant questionnaire assessing common symptoms and facilitating factors to CS in 25 items (Kregel et al, 2015;Mayer et al, 2012). Based on a validation study, a cutoff score of 40 points indicates the possibility that the symptoms are due to predominant CS pain (Neblett et al, 2014;Neblett et al, 2015).…”

Assessment and manifestation of central sensitisation across different chronic pain conditions

“…Pain Sensitivity Questionnaire (PSQ) and the Central Sensitivity Index (CSI), have been developed (Ruscheweyh et al, 2009;Mayer et al, 2012;Nijs et al, 2014) to assess various aspects of the clinical pain perceived. Significant correlations have been observed between PSQ scores and pain intensity Figure 1 A schematic illustration of how the different sensitisation processes may contribute to the assessed pain reaction (pain threshold).…”