2019 年 36 巻 4 号 p. 505-507
Central sensitization (CS) is defined as an amplification of neural signaling within the central nervous system that elicits pain hypersensitivity and increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input. Evaluation of central sensitization is assessed by Quantitative Sensory Testing (QST), Brain imaging, and self–administered questionnaire. In the case of knee osteoarthritis, a pressure pain monitor (AlgoMed, Medoc) is used to compress the non–painful forearm at 1kg/s. The pressure felt by the subject as NRS 1 is measured three times at 30–second intervals, and the mean of three times is adopted. The Wind Up phenomenon is evaluated using a method called Temporal Summation (TS). The TS is assessed by differences in the initial and final pain intensity of multiple repeated stimuli, such as pressure and heat stimuli. Decreased descending pain control systems are assessed by the degree to which pain is reduced when noxious stimuli are added outside of pain sites. TS and CPM are used as indicators of central sensitization at the research level, but are rarely used clinically. The reasons for this include the high cost of equipment for evaluation and the time required for measurement. Central Sensitization Inventory (CSI) has been developed as an evaluation of CSS, and high validity and reliability have been reported.
CSI consists of Part A (CSI score), which questions the common health–related symptoms of CSS, and Part B, which questions the presence or absence of a history of disease characteristic of CSS.
