Quantitative Sensory Testing Discriminates Central Sensitization Inventory Scores in Participants with Chronic Musculoskeletal Pain: An Exploratory Study.

Abstract

The Central Sensitization Inventory (CSI) is often used in clinical settings to screen for the presence of central sensitization. However, various cutoff scores have been reported for this tool, and scores have not been consistently associated with widespread pain sensitivity as measured with quantitative sensory testing (QST). The purpose of this study was to compare QST profiles among asymptomatic controls and participants with chronic musculoskeletal pain (CMP), and to determine the association between self-report questionnaires and QST in participants with CMP. Twenty asymptomatic controls and 46 participants with CMP completed the CSI, PROMIS-29, and QST assessments of mechanical and thermal pain thresholds remote to the area of pain. Receiver Operating Characteristic analysis revealed a cutoff score of 33.5 for the CSI. PROMIS-29 Quality of Life (QOL) inventory and QST measures were compared between low and high CSI groups. The high CSI group (n=19) had significantly lower mechanical and thermal pain thresholds, and larger impairments in QOL measures, compared to the low CSI group (n=27) and asymptomatic controls. Participants with CSI scores <33.5 presented similarly to asymptomatic controls. Anxiety, pain interference, and CSI scores demonstrated the highest number of significant associations to QST measures. A cutoff score of 33.5 on the CSI may be useful for discriminating widespread pain sensitivity and quality of life impairments in participants with CMP. Future studies should consider how the presence of high or low CSI may impact differential diagnosis, prognosis, and treatment responsiveness for patients with primary or secondary CMP.