Feng Beibei, Hu Xiaoqian, Lu William Weijia, Wang Yuling, Ip Wing Yuk
Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, People's Republic of China.
Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR, People's Republic of China.
J Pain Res. 2022 Feb 15;15:467-477. doi: 10.2147/JPR.S348842. eCollection 2022.
Central sensitization (CS) is frequently reported in chronic pain, and the central sensitization inventory (CSI) is popularly used to assess CS. However, a validated Chinese CSI is lacking and its predictive ability for the comorbidity of central sensitivity syndromes (CSSs) remains unclear. Hence, this study aimed to generate the Chinese CSI (CSI-C) with cultural adaptation and examine its psychometric properties.
The CSI-C was formulated through forward and backward translation, panel review and piloting and then validated among patients with chronic pain (n = 235). Its internal consistency, test-retest reliability, and concurrent validity were measured. An exploratory factor analysis (EFA) was performed for the construct validity. Receiver operating characteristic (ROC) analysis was employed to determine the discriminative ability in the presence of comorbidity of CSSs.
About 70% of the participants in the study experienced at least mild CS symptoms. CSI-C demonstrates a high internal consistency (Cronbach's alpha = 0.896) and excellent test-retest reliability (ICC = 0.932). CSI-C scoring was significantly correlated with pain intensity (r = 0.188), EQ-5D index (r = -0.375), anxiety (r=0.525), and depression (r = 0.467). The EFA generated a 5-factor model, including physical symptoms, emotional distress, hypersensitivity syndromes and so on. An CSI cutoff of 42 had a sensitivity of 71.4% and a specificity of 70% for identifying chronic pain patients with ≥2 CSSs.
The CS manifestations are prevalent in those with persistent pain. CSI-C is a reliable and valid instrument for measuring CS. A CSI score ≥42 may predict the comorbidity of 2 or above CSSs in patients with chronic pain.
中枢敏化（CS）在慢性疼痛中经常被报道，中枢敏化量表（CSI）被广泛用于评估CS。然而，缺乏经过验证的中文CSI，其对中枢敏感综合征（CSSs）合并症的预测能力仍不明确。因此，本研究旨在通过文化调适生成中文CSI（CSI-C）并检验其心理测量特性。
通过正向和反向翻译、专家小组评审和预试验制定CSI-C，然后在慢性疼痛患者（n = 235）中进行验证。测量其内部一致性、重测信度和同时效度。进行探索性因素分析（EFA）以评估结构效度。采用受试者工作特征（ROC）分析来确定在存在CSSs合并症时的判别能力。
研究中约70%的参与者至少经历过轻度CS症状。CSI-C表现出高内部一致性（Cronbach's α = 0.896）和出色的重测信度（ICC = 0.932）。CSI-C评分与疼痛强度（r = 0.188）、EQ-5D指数（r = -0.375）、焦虑（r = 0.525）和抑郁（r = 0.467）显著相关。EFA生成了一个五因素模型，包括躯体症状、情绪困扰、过敏综合征等。CSI临界值为42时，识别患有≥2种CSSs的慢性疼痛患者的敏感性为71.4%，特异性为70%。
CS表现在持续性疼痛患者中普遍存在。CSI-C是一种可靠且有效的测量CS的工具。CSI评分≥42可能预测慢性疼痛患者中2种或以上CSSs的合并症。
