Development of a Central Sensitization Inventory short form using data from twenty-three countries
Por:
Neblett R, Navarrete J, Knezevic A, Madi M, Caumo W, Wang LY, Ip WY, Culmsee-Holm L, Nim C, Kregel J, Paul van Wilgen C, Mikkonen J, Pitance L, Klute M, Bilika P, Bid DD, Chiarotto A, Testa M, Viti C, Nishigami T, Kim MS, Sharma S, Jha J, Kahrizi S, Noorollahzadeh K, Tarnacka B, Esin O, Cuesta Vargas A, Midenfjord I, Simrén M, Wiangkham T, Bombela V, Sánchez-Martínez N, Forero CF and Luciano JV
Publicada:
1 jun 2026
Ahead of Print:
1 mar 2026
Resumen:
The Central Sensitization Inventory (CSI) assesses central sensitization-related symptoms, but its 25-item length may limit its use in large-scale research or routine clinical practice. Therefore, the aim was to develop a short version of the CSI, using a large international sample of 7862 participants across 23 countries. A multi-step Rasch analysis was applied to the 25-item version of the CSI using a training-validation paradigm to identify the subset of items that best fit a unidimensional model. Then, an expert committee reviewed the face-content validity of each item. A 7-item solution was ultimately developed (Chi-Square Value = 794.728, df = 20; p-value < 0.001; CFI = 0.96; TLI = 0.96; RMSEA = 0.09, 90%CI [0.09-0.10]; SRMR= 0.05). Internal consistency was adequate for both the CSI-25 (alpha = 0.93; omega = 0.93) and CSI-7 (alpha = 0.85; omega = 0.85). Both versions demonstrated strong discriminative validity in identifying subgroups with presumed different levels of central sensitization-related symptoms. As expected, CSI-25 and CSI-7 scores increased progressively from healthy control participants (who scored lowest) to single-site non-spinal chronic pain, chronic spinal pain, multi-site chronic pain, and fibromyalgia (who scored highest). CSI-7 Receiver Operating Characteristic curves showed excellent sensitivity and specificity, particularly in differentiating fibromyalgia from healthy control participants (area under the curve = 0.98; sensitivity of 92% and specificity of 93%). CSI-7 severity levels were empirically derived to aid clinical interpretation. To sum up, the CSI-7 offers an efficient, unidimensional, and internally consistent alternative to the CSI-25 for international use. Perspective: The CSI-7 offers a brief, clinically useful screening tool for identifying central sensitization-related symptoms across diverse pain conditions. Derived from international data, it retains the psychometric strength of the full CSI while reducing patient burden, supporting efficient assessment in busy clinical and research settings.
Filiaciones:
Neblett R:
PRIDE Research Foundation, Dallas, TX
Navarrete J:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
Knezevic A:
Faculty of Medicine, University of Novi Sad, Serbia
Medical Rehabilitation Clinic, Clinical Centre of Vojvodina. Novi Sad, Serbia
Madi M:
Department of Physical, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 33012 Zarqa 13133, Jordan
Caumo W:
Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Anesthesiologist, Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Laboratory of Pain and Neuromodulation at UFRGS, Porto Alegre, Brazil
Associate Professor of Pain and Anesthesia in Surgery Department, School of Medicine, UFRGS, Porto Alegre, Brazil
Wang LY:
Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, People's Republic China
Ip WY:
Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR, People's Republic China
Culmsee-Holm L:
Private Chiropractic practice, Copenhagen, Denmark
Nim C:
Medical Spinal Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
Kregel J:
Breederode Hogeschool, Rotterdam, the Netherlands
Paul van Wilgen C:
Transcare, Transdisciplinary Pain Center, the Netherlands
Pain in Motion International Research Group
Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
Mikkonen J:
Private Practice, Helsinki, Finland
Pitance L:
Neuro Musculoskeletal Lab - Institute of clinical research (IREC) - Université Catholique de Louvain - Brussels - Belgium
Department of Oral and maxillofacial surgery, Cliniques Universitaires Saint-Luc - Brussels - Belgium
Klute M:
Pain Clinic, Department of Anaesthesiology, University Medical Center, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
Bilika P:
Physiotherapy Department, University of Thessaly, 3rd km Old National Road Lamia-Athens, 35100 Lamia, Greece
Bid DD:
Sarvajanik College of Physiotherapy, Rampura, Surat - 395003, Gujarat, India
Chiarotto A:
Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Testa M:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
Viti C:
Studio Fisioterapico Viti, Bologna, Italy
Nishigami T:
Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan
Kim MS:
Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Sharma S:
Pain Management and Research Centre, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW 2065, Australia
Pain Management Research Institute, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and Northern Sydney Local Health District, Sydney, NSW, Australia
School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
Jha J:
Consultant Physiotherapist, Norvic International Hospital, Kathmandu, Nepal
Kahrizi S:
Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Noorollahzadeh K:
Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Tarnacka B:
Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
Esin O:
Kazan (Volga region) Federal University, Kazan, Russia
Clinic of Otorhinolaryngology, Kazan, Russia
Cuesta Vargas A:
Department of Physiotherapy of the Faculty of Health Science at the University of Malaga, (IBIMA), Spain
Faculty of Health at the Queensland University of Technology, Australia
Midenfjord I:
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Simrén M:
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wiangkham T:
Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
Bombela V:
Department of Internal Medicine ? 1, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Sánchez-Martínez N:
School of Medicine, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
Forero CF:
School of Medicine, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
Luciano JV:
Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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