title: The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample.
abstract: Central sensitization (CS) is a proposed physiological phenomenon in which central nervous system neurons become hyperexcitable, resulting in hypersensitivity to both noxious and non-noxious stimuli. The term central sensitivity syndrome (CSS) describes a group of medically indistinct (or nonspecific) disorders, such as fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome, for which CS may be a common etiology. In a previous study, the Central Sensitization Inventory (CSI) was introduced as a screening instrument for clinicians to help identify patients with a CSS. It was found to have high reliability and validity (test-retest reliability = .82; Cronbach's alpha = .88). The present study investigated a cohort of 121 patients who were referred to a multidisciplinary pain center, which specializes in the assessment and treatment of complex pain and psychophysiological disorders, including CSSs. A large percentage of patients (n = 89, 74%) met clinical criteria for one or more CSSs, and CSI scores were positively correlated with the number of diagnosed CSSs. A receiver operating characteristic analysis determined that a CSI score of 40 out of 100 best distinguished between the CSS patient group and a nonpatient comparison sample (N = 129) (area under the curve = .86, sensitivity = 81%, specificity = 75%).
  
  
  CONCLUSIONS
  The CSI is a new self-report screening instrument to help identify patients with CSSs, including fibromyalgia. The present study investigated CSI scores in a heterogeneous pain population with a large percentage of CSSs, and a normative nonclinical sample to determine a clinically relevant cutoff value.
authors.affiliation: PRIDE Research Foundation, Dallas, Texas, USA.
authors.forename: Randy
authors.initials: R
authors.lastname: Neblett
authors.forename: Howard
authors.initials: H
authors.lastname: Cohen
authors.forename: YunHee
authors.initials: Y
authors.lastname: Choi
authors.forename: Meredith M
authors.initials: MM
authors.lastname: Hartzell
authors.forename: Mark
authors.initials: M
authors.lastname: Williams
authors.forename: Tom G
authors.initials: TG
authors.lastname: Mayer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gatchel
mesh_terms: D000293:Adolescent; D000328:Adult; D059333:Central Nervous System Sensitization / Q000502:physiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055815:Young Adult