Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan.
Miura Internal Medicine Michiko Pediatrics Clinic, Marugame, Kagawa, Japan.
Pain Res Manag. 2019 Apr 8;2019:3916135. doi: 10.1155/2019/3916135. eCollection 2019.
Central sensitization (CS) and psychological factors are associated with pain intensity; however, the mediating role of CS on the relation between psychological factors and pain intensity remains unclear.
We performed mediation analysis to investigate how CS mediates relation between psychological factors and pain intensity.
Twenty patients with musculoskeletal pain were included in this cross-sectional study. Central sensitization inventory (CSI), one pain intensity-related outcome measure (Short-Form McGill Pain Questionnaire 2 (SFMPQ2)), and three psychological outcome measures (Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale-4 (PCS), and Tampa Scale for Kinesiophobia-11 (TSK)) of all participants were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess the indirect effects. The level of significance was set at 5%.
Mediation analysis showed that the HADS-anxiety, HADS-depression, and PCS had significant indirect effects on the pain ratings of CSI. Additionally, the direct effect was significant only for PCS.
The relationship among anxiety symptoms, depression symptoms, and pain intensity was completely mediated by CS. Furthermore, the relationship between catastrophic thinking and pain intensity was partially mediated by CS. Our findings suggest that CS mediates relation between psychological factors and pain intensity, and CS-focused intervention may be important.
中枢敏化（CS）和心理因素与疼痛强度有关；然而，CS 在心理因素与疼痛强度之间的关系中的中介作用尚不清楚。
我们进行了中介分析，以探讨 CS 如何调节心理因素与疼痛强度之间的关系。
本横断面研究纳入了 20 名肌肉骨骼疼痛患者。对所有参与者进行了中枢敏化量表（CSI）、一种与疼痛强度相关的测量工具（短式麦吉尔疼痛问卷 2 版（SFMPQ2））和三种心理测量工具（医院焦虑和抑郁量表（HADS）、疼痛灾难化量表-4 版（PCS）和运动恐惧量表-11 版（TSK））评估。采用 bootstrap 抽样程序的中介分析来评估间接效应。显著性水平设为 5%。
中介分析表明，HADS 焦虑、HADS 抑郁和 PCS 对 CSI 的疼痛评分有显著的间接影响。此外，PCS 的直接效应是显著的。
焦虑症状、抑郁症状和疼痛强度之间的关系完全由 CS 介导。此外，灾难性思维与疼痛强度之间的关系部分由 CS 介导。我们的研究结果表明，CS 调节了心理因素与疼痛强度之间的关系，以 CS 为重点的干预可能很重要。
