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J Pain Res. 2017 Sep 1;10:2109-2122. doi: 10.2147/JPR.S131479. eCollection 2017.

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

Author information

1
Postgraduate Program in Medical Sciences, School of Medicine.
2
Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre.
3
Laboratory of Pain and Neuromodulation.
4
Surgery Department, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre.
5
School of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul.
6
School of Medicine, Universidade Federal do Rio Grande do Sul.
7
Postgraduate Program in Health and Human Development, La Salle University Center, Canoas.
8
Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
9
PRIDE Research Foundation, Dallas, TX, USA.

Abstract

OBJECTIVES:

The 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 METHODS:

A 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.

RESULTS:

The 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).

CONCLUSION:

The 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.

KEYWORDS:

central sensitization; chronic pain; conditioned pain modulation; confirmatory factor analysis; cross-cultural adaptation; serum brain-derived neurotrophic factor

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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