Salbego Rafaela Stocker, Conti Paulo César Rodrigues, Soares Flávia Fonseca Carvalho, Ferreira Dyna Mara Araújo Oliveira, Herreira-Ferreira Matheus, de Lima-Netto Beatriz Amaral, Costa Yuri Martins, Bonjardim Leonardo Rigoldi
Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Eur J Pain. 2025 Feb;29(2):e4713. doi: 10.1002/ejp.4713. Epub 2024 Aug 9.
The central sensitization inventory (CSI) is a questionnaire that has been widely used as a tool for assessing symptoms associated with sensitization. However, its ability to identify individuals with this phenomenon has recently been questioned. The aim of this study was to assess the correlation of CSI with psychosocial and psychophysical factors in patients with painful TMD diagnosed according to diagnostic criteria for temporomandibular disorders (DC/TMD) and asymptomatic controls, as well as to determine the influence of these variables on the CSI scores variations.
This cross-sectional study with 77 patients diagnosed with painful TMD according to DC/TMD and 101 asymptomatic controls realized correlations between CSI, WUR, PPT, CPM and psychosocial questionnaires (HADS, PSQI, PCS and PSS). In cases where significant correlations existed, the potential influence of these variables on CSI variation was explored through linear regression analysis.
It has been found that the CSI correlates with psychosocial variables (anxiety, depression, catastrophizing, sleep and stress) (p < 0.0006) regardless of the presence of TMD, and that 68.9% of the variation in CSI scores can be influenced by all these variables (except stress). On the contrary, the CSI does not correlate with psychophysical parameters indicative of pain amplification (wind-up ratio and conditioned pain modulation) (p > 0.320).
CSI is more associated with psychosocial factors than with more robust indicators of probable central sensitization (CS), thus limiting its utility in detecting this phenomenon both in TMD patients and healthy individuals.
The research highlights a noteworthy relationship between the central sensitization inventory and psychological factors, emphasizing their substantial influence on inventory values. This correlation offers crucial insights into mental health markers within the questionnaire. Additionally, the lack of connection with pain amplification implies a necessary re-evaluation of the inventory's diagnostic suitability, especially in cases of painful temporomandibular disorders. Thus, caution is urged in its application for identifying CS in these individuals.
中枢敏化量表（CSI）是一种问卷，已被广泛用作评估与敏化相关症状的工具。然而，其识别有这种现象个体的能力最近受到了质疑。本研究的目的是评估CSI与根据颞下颌关节紊乱病诊断标准（DC/TMD）诊断的疼痛性颞下颌关节紊乱病患者及无症状对照者的心理社会和心理生理因素之间的相关性，并确定这些变量对CSI评分变化的影响。
这项横断面研究纳入了77例根据DC/TMD诊断为疼痛性颞下颌关节紊乱病的患者和101例无症状对照者，实现了CSI、WUR、PPT、CPM与心理社会问卷（HADS、PSQI、PCS和PSS）之间的相关性分析。在存在显著相关性的情况下，通过线性回归分析探讨这些变量对CSI变化的潜在影响。
研究发现，无论是否存在颞下颌关节紊乱病，CSI均与心理社会变量（焦虑、抑郁、灾难化、睡眠和压力）相关（p < 0.0006），且CSI评分68.9%的变化可受所有这些变量（压力除外）影响。相反，CSI与表明疼痛放大的心理生理参数（累积疼痛反应和条件性疼痛调制）不相关（p > 0.320）。
CSI与心理社会因素的关联比与可能的中枢敏化（CS）更可靠指标的关联更强，因此限制了其在检测颞下颌关节紊乱病患者和健康个体中这种现象的效用。
该研究突出了中枢敏化量表与心理因素之间值得注意的关系，强调了它们对量表值的重大影响。这种相关性为问卷中的心理健康指标提供了关键见解。此外，与疼痛放大缺乏关联意味着有必要重新评估该量表的诊断适用性，尤其是在疼痛性颞下颌关节紊乱病的情况下。因此，在将其用于识别这些个体中的CS时应谨慎。
