Supporting data for thesis "Pain sensitization in peripheral entrapment neuropathy and associated neuroplasticity by multimodal functional magnetic resonance imaging"

First of all, this thesis produced the Chinese CSI through forward translation, backward translation, expert panel, and piloting. The Chinese CSI generated was then validated among 419 participants with chronic pain. Our results confirmed the excellent test-retest reliability (Intraclass correlation coefficient=0.932, Cronbach’s alpha =0.9) and good criterion and construct validities of the Chinese CSI. Furthermore, 155 CTS patients and 57 normal controls were enrolled to examine the neuropathic pain and pain sensitization profiles in CTS and the associated risk factors. Of the CTS participants, over 60% presented a sign of clinical central sensitization screened by the CSI, more than 70% were determined as potential or very likely neuropathic pain, and around one quarter had anxiety or depression. Anxiety was found a risk factor associated with central sensitization in CTS (adjusted OR =1.31, 95% CI 1.08-1.59). With regard to the brain plasticity changes related with the central pain processing in CTS, significantly decreased 

cerebral blood flow and maladaptive functional brain connectivity were demonstrated in brain regions involving sensory, affective, and cognitive processing. There were significant associations between the cortical plasticity alterations (cerebral blood flow and functional connectivity) and clinical outcomes (symptom severity, pain sensitization, pain intensity, anxiety, depression, and general health) in the CTS patients. 

In conclusion, this thesis provides a validated Chinese CSI to measure and screen central sensitization and presents a picture of neuropathic pain and pain sensitization profiles in CTS patients as well as the associated predictors. More importantly, the thesis adds insightful evidence in the CTS-associated central pain processing mechanisms by disclosing new neuroimaging biomarkers, which thereby facilitating optimal treatments targeting cortical regions in a multi-disciplinary approach for CTS.