Abstract：
BACKGROUND: Chronic neck pain (CNP) is a global public health problem, with high prevalence and absenteeism rates. Central sensitization (CS) as a basis for chronic pain may play an essential role in its development and progression. It is often comorbid with low conditioned pain modulation (CPM) effects, cognitions, and psychological problems.
OBJECTIVE: The purposes of this study were to (1) explore the relationship between pain-related cognitions and psychological factors, CPM effects, and the central sensitization inventory (CSI) scores; and (2) determine whether cognitions and psychological factors can predict CSI scores and CPM effects in individuals with CNP.
METHODS: Fifty-four individuals with CNP were recruited for this cross-sectional study. The following outcome measures were evaluated: The CSI (screening tool) was compared with the cold pressor test (CPT), which was the psychophysical test used to assess the CPM; neck pain intensity using the visual analogue scale (VAS), as well as pain-related cognitions (including kinesiophobia and pain catastrophization) and psychological states (including anxiety and depression) using self-report questionnaires.
RESULTS: CSI score was not associated with the CPM effect (r = 0.257, p > 0.05), and no cognitions or psychological factors were associated with CPM (p > 0.05), but CSI score was moderately positively correlated with kinesiophobia (r = 0.554, p < 0.01), lowly positively correlated with pain catastrophization (r = 0.332, p = 0.017) and anxiety (r = 0.492, p < 0.01), but not depression (r = 0.207, p = 0.132). Multiple linear regression analysis showed that kinesiophobia (B = 1.308, p < 0.01) and anxiety (B = 1.806, p = 0.02) were significant positive predictors of CSI score.
CONCLUSIONS: The findings confirm some of our hypotheses. Accordingly, the findings inferred that the CSI does not seem to respond to CPM effect in patients with CNP effectively. In addition, CSI score was associated with cognitions and psychological factors, of which kinesiophobia and anxiety were effective predictors. In clinical practice, pain-related cognitions and psychological factors should be fully considered to manage neck pain efficiently.
OBJECTIVE: The purposes of this study were to (1) explore the relationship between pain-related cognitions and psychological factors, CPM effects, and the central sensitization inventory (CSI) scores; and (2) determine whether cognitions and psychological factors can predict CSI scores and CPM effects in individuals with CNP.
METHODS: Fifty-four individuals with CNP were recruited for this cross-sectional study. The following outcome measures were evaluated: The CSI (screening tool) was compared with the cold pressor test (CPT), which was the psychophysical test used to assess the CPM; neck pain intensity using the visual analogue scale (VAS), as well as pain-related cognitions (including kinesiophobia and pain catastrophization) and psychological states (including anxiety and depression) using self-report questionnaires.
RESULTS: CSI score was not associated with the CPM effect (r = 0.257, p > 0.05), and no cognitions or psychological factors were associated with CPM (p > 0.05), but CSI score was moderately positively correlated with kinesiophobia (r = 0.554, p < 0.01), lowly positively correlated with pain catastrophization (r = 0.332, p = 0.017) and anxiety (r = 0.492, p < 0.01), but not depression (r = 0.207, p = 0.132). Multiple linear regression analysis showed that kinesiophobia (B = 1.308, p < 0.01) and anxiety (B = 1.806, p = 0.02) were significant positive predictors of CSI score.
CONCLUSIONS: The findings confirm some of our hypotheses. Accordingly, the findings inferred that the CSI does not seem to respond to CPM effect in patients with CNP effectively. In addition, CSI score was associated with cognitions and psychological factors, of which kinesiophobia and anxiety were effective predictors. In clinical practice, pain-related cognitions and psychological factors should be fully considered to manage neck pain efficiently.
摘要：
背景：慢性颈痛（CNP）是全球性的公共卫生问题，患病率和缺勤率高。中枢致敏（CS）作为慢性疼痛的基础，可能在其发展和进展中起重要作用。它通常与低条件性疼痛调制（CPM）效应并存，认知，和心理问题。
目的：本研究的目的是（1）探讨疼痛相关认知与心理因素之间的关系，CPM效应,和中央敏感性清单（CSI）得分；（2）确定认知和心理因素是否可以预测CNP个体的CSI得分和CPM效应。
方法：本横断面研究招募了54名CNP患者。评估了以下结果指标：将CSI（筛选工具）与冷加压试验（CPT）进行比较，这是用于评估CPM的心理物理测试；使用视觉模拟量表（VAS）的颈部疼痛强度，以及使用自我报告问卷的疼痛相关认知(包括运动恐惧症和疼痛灾难化)和心理状态(包括焦虑和抑郁)。
结果：CSI评分与CPM效应无关（r=0.257，p>0.05），认知或心理因素与CPM无相关性(p>0.05),CSI评分与运动恐惧症呈中度正相关(r=0.554,p<0.01),与疼痛灾难化（r=0.332，p=0.017）和焦虑（r=0.492，p<0.01）呈低正相关，但不是抑郁(r=0.207，p=0.132)。多元线性回归分析显示，运动恐惧症（B=1.308，p<0.01）和焦虑（B=1.806，p=0.02）是CSI评分的显著正预测因子。
结论：这些发现证实了我们的一些假设。因此，研究结果推断,CSI似乎对CNP患者的CPM效应没有有效反应.此外,CSI评分与认知和心理因素相关，其中运动恐惧症和焦虑是有效的预测因素。在临床实践中,应充分考虑与疼痛相关的认知和心理因素，以有效地控制颈部疼痛。
目的：本研究的目的是（1）探讨疼痛相关认知与心理因素之间的关系，CPM效应,和中央敏感性清单（CSI）得分；（2）确定认知和心理因素是否可以预测CNP个体的CSI得分和CPM效应。
方法：本横断面研究招募了54名CNP患者。评估了以下结果指标：将CSI（筛选工具）与冷加压试验（CPT）进行比较，这是用于评估CPM的心理物理测试；使用视觉模拟量表（VAS）的颈部疼痛强度，以及使用自我报告问卷的疼痛相关认知(包括运动恐惧症和疼痛灾难化)和心理状态(包括焦虑和抑郁)。
结果：CSI评分与CPM效应无关（r=0.257，p>0.05），认知或心理因素与CPM无相关性(p>0.05),CSI评分与运动恐惧症呈中度正相关(r=0.554,p<0.01),与疼痛灾难化（r=0.332，p=0.017）和焦虑（r=0.492，p<0.01）呈低正相关，但不是抑郁(r=0.207，p=0.132)。多元线性回归分析显示，运动恐惧症（B=1.308，p<0.01）和焦虑（B=1.806，p=0.02）是CSI评分的显著正预测因子。
结论：这些发现证实了我们的一些假设。因此，研究结果推断,CSI似乎对CNP患者的CPM效应没有有效反应.此外,CSI评分与认知和心理因素相关，其中运动恐惧症和焦虑是有效的预测因素。在临床实践中,应充分考虑与疼痛相关的认知和心理因素，以有效地控制颈部疼痛。
