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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

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



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.


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.


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).


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.


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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