Table 4.
Reported assessment of Human Assumed Central Sensitisation in patients with chronic low back pain.
| Questionnaires | ||||
|---|---|---|---|---|
| CSI (n = 23) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Comparison between assessment methods | |
| Ansuategui Echeita, 2020a [41] | Quantify the severity of symptoms CS | Not reported | CSI with Waddle Non-organic Signs. | |
| Ansuategui Echeita, 2020b [42] | Quantify the severity of symptoms CS | Not reported | CSI with Lifting capacity | |
| Bid, 2017 [46] | A score above 40 indicates the presence of CS | Not reported | Comparing CSI (CS group/NoCS group) with PPT scores, numeric pain rating scale, Roland Morris Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire, Trunk Flexors Endurance, and Trunk Extensor Endurance | |
| Bilika, 2020 [47] | Identify symptoms associated with CS | Internal consistency: Cronbach’s α = 0.994 Test-retest: ICC = 0.993 |
CSI with pain catastrophizing scale. | |
| Chiarotto, 2018 [48] | Identify patient’s symptoms related to CS | Internal consistency: Cronbach’s α = 0.87 |
No comparison | |
| Clark, 2018 [49] | Person’s symptoms likely to be attributable to CS | Not reported | CSI (CSI High group/CSI Low group) with Sensory Seeking, Sensory Sensitive, trait anxiety, Low Registration, and Sensation Avoidance. | |
| Clark, 2019 [50] | Individual’s symptoms likely to be attributable to CS | Not reported | CSI with sensory profiles, Sensory Sensitivity, sensation avoiding, low registration, sensation seeking, and trait anxiety. | |
| Huysmans, 2018 [55] | The degree of symptoms of CS | Not reported | CSI and 1-minute stair-climbing test, Pain catastrophizing scale, visual analogue scale at this moment, Brief Illness Perception Questionnaire, Quebec Back Pain Disability Scale, and Tampa Scale for Kinesiophobia. | |
| Ide, 2020 [56] | Assessing CS syndrome (CSS) | Not reported | CSI and EuroQOL 5-dimension, Neck Disability Index, and Oswestry Disability Index. | |
| Knezevic, 2018 [57] | Assesses 25 symptom dimensions associated with CS and CSS. | Internal consistency: Cronbach α = 0.909 Test-retest: ICC = 0.947 |
No comparison | |
| Knezevic, 2020 [58] | A measure of symptoms related to CS and CSS | Not reported | CSI with Medical Outcomes Study, Fear-Avoidance Components Scale, Oswestry Disability Index, Short Form-36, Pain Catastrophizing Scale, pain intensity, and Multidimensional Scale of Perceived Social Support. | |
| Kregel, 2016 [59] | Measure the overlapping symptom dimensions present in CS. | Internal consistency: Cronbach α= 0.91 Test-retest: ICC = 0.88 |
No comparison | |
| Kregel, 2018 [60] | An indirect tool for CS symptomatology evaluation | Not reported | CSI with PPT, CPM, current pain intensity, quality of life, pain disability, and pain catastrophizing score | |
| Leemans, 2020 [61] | Identify key symptoms associated with CS | Not reported | No comparison | |
| Mayer, 2012 [25] | Assess symptoms associated with CS | Internal consistency: Cronbach α = 0.879. Test-retest: ICC = 0.817 |
No comparison | |
| McKernan, 2019 [62] | Assess key polysomatic symptoms associated with a CS disorder | Not reported | CSI with Trauma History Questionnaire, PTSD, Michigan Body Map, McGill Pain Questionnaire, Multidimensional Experiential Avoidance Questionnaire. | |
| Mibu, 2019 [64] | Assess health-related symptoms in CSS | Sensitivity: CS+ 1 or CS− 1: 73.7% (cut-off: 20) CSS+ 2 or CSS− 2: 69.2% (cut-off: 28) Specificity: CS+ 1 or CS− 1: 37.7% CSS+ 2 or CSS− 2: 69.2% |
CSI and duration of symptoms, EQ-5D, pain intensity, pain interference, Widespread Pain Index score, PPT, and temporal summation. | |
| Miki, 2020 [65] | Significant deficits in CS | Not reported | CSI (low CSI group/high CSI group) with pain catastrophizing scale, Tampa Scale for Kinesiophobia, Hospital Anxiety and Depression Scale, pain intensity for LBP, pain intensity for leg pain, Roland Morris Disability Questionnaire, and EuroQoL 5 dimensions. | |
| Neblett, 2017 [67] | Screener for high risk of having CSS | Not reported | Explored the five CSI severity levels with patient-reported outcomes: for pain intensity, perceived disability, depressive symptoms, sleep disturbance, pain-reported outcomes; pain intensity, perceived disability, depressive symptoms, sleep disturbance, pain-related anxiety, and somatization-related symptoms. | |
| Noord, van der, 2018 [68] | Identifying symptoms of CS in patients with chronic pain disorders | Not reported | CSI part A with CSI part B, depression, anxiety, WPI, pain intensity, and pain catastrophizing scale. | |
| Serrano-Ibáñez, 2020 [69] | Severity of CS | Not reported | CSI with daily routines, decreased physical activity, diminished social support, emotional distress, and pain intensity. | |
| Sharma, 2020 [70] | Assess somatic and emotional health-related symptoms associated with CS | Internal consistency: Cronbach’s α = 0.87 ICC = 0.98 (95% CI: 0.97, 0.99) |
CSI with the pain catastrophizing scale (strong correlation), number of pain descriptors(McGill Pain Questionnaire) (moderate correlation), and pain intensity (weak correlation) | |
| MBM (n = 1) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Version | Comparison |
| McKernan, 2019 [62] | Indicate widespread pain related to CS | Not reported | Revised version [107] | Exposure to trauma and PTSD increases CS. Findings need to be objectified with laboratory markers of CS. |
| MPQ (n = 1) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Version | Comparison |
| McKernan, 2019 [62] | Assessing various dimensions of pain (Indicator for CS) | Not reported | SF-MPQ-2 [108,109] | Exposure to trauma and PTSD increases CS. Findings need to be objectified with laboratory markers of CS. |
| WPI (n = 2) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Version | Comparison |
| Aoyagi, 2019 [43] | Assesses experience pain or tenderness in 19 specific body areas. As a continuous variable to measure CS severity | Not reported | as part of the 2011 FM survey [110,111] | FM positive when WPI ≥ 7 and ≥ 5 or WPI 3–6 and SS ≥ 9. Conclusion article: FM positive = CS |
| Aoyagi, 2020 [44] | Scores from the WPI and SS are combined to determine the presence and severity of CS. | Not reported | As part of the 2011 FM survey [110,111] | Cutoff scores of ≥ 12 with a combination of either WPI score ≥ seven and SS score ≥ five or WPI score 3 to 6 and SS score ≥ 9 distinguish those with CS as FM positive. Higher total scores indicate a greater degree of CS. |
| QST measurements | ||||
| PPT (n = 7) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Method /location(s) | Comparison |
| Aoyagi, 2019 [43] | Identifying individuals with CS | Not reported | Handheld algometer Thumbnail Lower back |
PPT values were compared between the FM-negative and FM-positive group. FM scores were used as a dichotomous variable to identify the presence of CS and as a continuous variable to examine associations between CS, QST and other self-reported measures. |
| Aoyagi, 2020 [44] | Identifying individuals with CS | Not reported | Handheld algometer Thumbnail Lower leg |
PPT values were compared between the FM-negative and FM-positive group. |
| Kregel, 2018 [60] | To objectify CS symptomatology/evaluation of CS symptoms | Not reported | Handheld algometer Lower back Hand Upper leg |
The CSI compared with measures of pain intensity, quality of life, pain disability, pain catastrophizing, PPT, and CPM |
| Leemans, 2020 [61] | Altered sensory processing, including signs of CS | Not reported | Handheld algometer Three spots in the lower back 2nd Toe |
No conclusions about CS |
| Mibu, 2019 [64] | The lowest tertile PPT, in combination with a positive TS, are patients with CS. | Not reported | Handheld algometer Lower arm |
No comparison |
| Tesarz, 2015 [72] | It covers all relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation. | Not reported | Handheld algometer Low back Dorsum hand |
No comparison |
| Tesarz, 2016 [73] | It covers all relevant aspects of the somatosenosory system, including large and small fibre functions, and signs of central sensitisation | Not reported | Handheld algometer Low back Dorsum hand |
No comparison |
| CPM (n = 3) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Method/location(s) | Comparison |
| Aoyagi, 2019 [43] | Discriminate individuals with CS | Not reported | PPT before and after. Conditioning painful stimulus cuff to ischemic pain. Thumbnail Lower back |
PPT values were compared between the FM-negative and FM-positive group. FM scores were used as a dichotomous variable to identify the presence of CS and as a continuous variable to examine associations between CS, QST and other self-reported measures. |
| Kregel, 2018 [60] | To objectify CS symptomatology/evaluation of CS symptoms | Not reported | Cold Pressor Test. 1 min. 22 °C, 2 min. 12 °C, 30 s. wait, PPT measurements Upper leg |
The CSI compared with measures of pain intensity, quality of life, pain disability, pain catastrophizing, PPT, and CPM |
| Leemans, 2020 [61] | Altered sensory processing, including signs of CS, to evaluate the efficacy of the descending inhibitory modulation of pain | Not reported | Cold pressor test. 0.7 °C until intolerable or 2 min. PPT before and after 2nd Toe |
No comparison |
| TS (n = 4) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Method/ location(s) | Comparison |
| Hubscher, 2014 [54] | Thermal pain thresholds and tolerance (heat/cold) and TS of heat pain. The distal site as a marker of possible CS. | Not reported | One sequence of 10 consecutive heat pulses of <1-s duration at an interstimulus interval of 0.33 Hz was delivered. The temperature increased from 41 °C to a maximum of 47 °C at a rate of 10 °C/3. The pain intensity of each heat pulses was assessed. Location: 2 sites: on the surface of the low back and a distal site, the volar surface of the forearm |
No comparison |
| Mibu, 2019 [64] | The lowest tertile PPT, in combination with a positive TS, are patients with CS. | Not reported | Previous determined PPT was applied ten times Lower arm |
No comparison |
| Tesarz, 2015 [72] | It covers all relevant aspects of the somatosenosory system, including large and small fibre functions, and signs of central sensitisation | Not reported | Pinprick 256N Low back Dorsum hand |
No comparison |
| Tesarz, 2016 [73] | It covers all relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation. | Not reported | Pinprick 256N Low back Dorsum hand |
No comparison |
| Thermal QST (n = 3) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Method/Location(s) | Comparison |
| Hubscher, 2014 [54] | Thermal pain thresholds and tolerance (heat/cold) and TS of heat pain. The distal site as a marker of possible CS. | Not reported | CPT, CPTol, HPT, HPTol. 2 sites: on the surface of the low back and a distal site, the volar surface of the forearm |
No comparison |
| Tesarz, 2015 [72] | All relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation. | Not reported | TSA 2001-II CDT, WDT, TSL, CPT, HPT. Low back Dorsum hand |
No comparison |
| Tesarz, 2016 [73] | All relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation. | Not reported | TSA 2001-II CDT, WDT, TSL, CPT, PHS, HPT. Low back Dorsum hand |
No comparison |
| Other QST measures (n = 2) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Method/Location(s) | Comparison |
| Tesarz, 2015 [72] | All relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation | Not reported | MPT (Pinprick stimulators), MPS (Pinprick stimulators), DMA (brush, cotton wool and Q-tip), MDT (von Frey filaments), VDT (tuning fork 64 Hz) Low back Dorsum hand |
No comparison |
| Tesarz, 2016 [73] | It covers all relevant aspects of the somatosenosory system, including large and small fibre functions and signs of central sensitisation. | Not reported | MPT (Pinprick stimulators), MPS (Pinprick stimulators), DMA (brush, cotton wool and Q-tip), MDT (von Frey filaments), VDT (tuning fork 64 Hz) Low back Dorsum hand |
No comparison |
| No measurements (n = 6) | ||||
| Study (1st author, year) | The goal of the test | Clinimetrics | Explanation of possible HACS measures | |
| Ashina, 2018 [45] | Not reported | Not reported | Discussion section: lower cephalic and extra-cephalic PPT and higher TTS in the chronic headache group than episodic headache and control groups suggest that comorbidity of back pain and frequent headaches is associated with signs of CS. TTS is increased, suggesting that low back pain can induce CS. | |
| Defrin, 2014 [52] | Not reported | Not reported | Results section: the development of tactile allodynia and inference of CS has more to do with individual predisposition than with the intensity of the precipitating noxious input. Discussion section: Neural mechanism: CS and ectopic hyperexcitability. The presence of tactile allodynia strongly implies the presence of CS. The observed ~60% incidence of leg allodynia in radicular patients suggests that peripheral nervous system generators of leg pain often induce CS. The 40% who did not (yet) develop CS despite comparable leg pain were presumably less prone to doing so. |
|
| Dixon, 2016 [53] | Not reported | Not reported | CS is used as an explanatory model of the results | |
| Mehta, 2017 [63] | Not reported | Not reported | Changes in PPT and CPM are consistent with normalization of peripheral and CS | |
| Müller, 2019 [66] | Not reported | Not reported | Negative findings for QST as a predictor for FBSS. They conclude that the negative findings do not necessarily mean that central hypersensitivity is not involved in FBSS. | |
| Smart, 2012 [71] | Not reported | Not reported | Based on clinical examination, patients were, i.e., CS | |
Abbreviations: CDT, cold detection threshold, CI: confidence interval, CPM: conditioned pain modulation, CPT, cold pain threshold, CPTol: cold pain tolerance, CS: central sensitisation, CSI: central sensitisation inventory, CSS: central sensitisation syndromes, DMA, dynamic mechanical allodynia, FBSS: Failed back surgery syndrome, FM: fibromyalgia, HPT, heat pain threshold, HPTol: heat pain tolerance, ICC: intraclass correlation, LBP: low back pain, MBM: Michigan Body Map, MDT, mechanical detection threshold, MPQ: McGill Pain Questionnaire, MPS, mechanical pain sensitivity, MPT, mechanical pain threshold, PHS: paradoxical heat sensations, PPT, pressure pain threshold, PPT: pressure pain threshold, PTSD: post-traumatic stress disorder, QST: quantitative sensory testing, SS: symptom severity, TS: Temporal summation, TSA: Advanced thermosensory stimulator, TSL, thermal sensory limen, TTS: total tenderness score, VDT, vibration detection threshold, WDT, warm detection threshold, WPI: Widespread Pain Index, WUR, wind-up ratio,. 1: CS was determent based on the lowest tertile of the PPT data and positive values of TS. 2: CSS was determent based on the number of CSS in the CSI part B.