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Is Central Sensitisation the Missing Link of Persisting Symptoms after COVID-19 Infection?, 2021, Goudman et al

Discussion in 'Long Covid research' started by Andy, Dec 13, 2021.

  1. Andy

    Andy Committee Member

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    Location:
    Hampshire, UK
    Abstract

    Patients recovered from a COVID-19 infection often report vague symptoms of fatigue or dyspnoea, comparable to the manifestations in patients with central sensitisation. The hypothesis was that central sensitisation could be the underlying common aetiology in both patient populations.

    This study explored the presence of symptoms of central sensitisation, and the association with functional status and health-related quality of life, in patients post COVID-19 infection. Patients who were previously infected with COVID-19 filled out the Central Sensitisation Inventory (CSI), the Post-COVID-19 Functional Status (PCFS) Scale and the EuroQol with five dimensions, through an online survey. Eventually, 567 persons completed the survey. In total, 29.73% of the persons had a score of <40/100 on the CSI and 70.26% had a score of ≥40/100.

    Regarding functional status, 7.34% had no functional limitations, 9.13% had negligible functional limitations, 37.30% reported slight functional limitations, 42.86% indicated moderate functional limitations and 3.37% reported severe functional limitations. Based on a one-way ANOVA test, there was a significant effect of PCFS Scale group level on the total CSI score (F(4,486) = 46.17, p < 0.001). This survey indicated the presence of symptoms of central sensitisation in more than 70% of patients post COVID-19 infection, suggesting towards the need for patient education and multimodal rehabilitation, to target nociplastic pain.

    Open access, https://www.mdpi.com/2077-0383/10/23/5594/htm
     
  2. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    3,637
    We really don’t make as much use of questionnaires as we could.

    Perhaps orchestras could employ pianists on the basis of their ability to fill in questionnaires measuring musicality, cancer surgery could be guided solely by answers to a cancerosity questionnaire and in general patients be treated on the basis of questionnaires completed by their doctor about how much poorlyness they look to have.

    (Central Sensitivity may or may not exist, and may or may not have anything to do with the topics purportedly addressed in this paper, but we have no idea if the arbitrary questionnaires used have anything to do with anything other than their compilers’ fantasy world.)
     
    Daisybell, Milo, spinoza577 and 21 others like this.
  3. Trish

    Trish Moderator Staff Member

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    UK
    This is circular thinking. Since the so called central sensitisation questionniare is just a list of symptoms and diagnosis is on the basis of number of symptoms, it's hardly surprising that Long Covid, which has a lot of symptoms, would correlate with it.

    It's a bit like saying rainbows have lots of colours, and flower gardens have lots of colours, so therefore flower gardens are rainbows.
     
    sebaaa, Milo, alex3619 and 19 others like this.
  4. Cheshire

    Cheshire Moderator Staff Member

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    4,675
    What's the original study that linked questionnaires to CS?
     
  5. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Not sure if this is the start of the questionnaire approach to identifying Central Sensitisation, but if not it is certainly early on

    The Development and Psychometric Validation of the Central Sensitization Inventory (CSI)
    (2013) Tom G. Mayer, M.D., Randy Neblett, M.A., LPC, BCB, Howard Cohen, M.D., Krista J. Howard, Ph.D., Yun Hee Choi, M.A., Mark J. Williams, Ph. D., Yoheli Perez, P.T., D.P.T., and Robert J. Gatchel, Ph.D., ABPP
    Pain Pract. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248986/

    Our thread discussing it https://www.s4me.info/threads/the-d...ntory-csi-2013-mayer-et-al.20180/#post-339548
     
    alktipping, spinoza577, Hutan and 3 others like this.
  6. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Exactly.

    For this study to have any sort of construct validity, they have to go beyond questionnaires.
     
    Ash, alktipping, FMMM1 and 5 others like this.
  7. Sean

    Sean Moderator Staff Member

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    Is Central Sensitisation the Missing Link of Persisting Symptoms after COVID-19 Infection?

    No.
     
    Solstice, Ebb Tide, Ash and 16 others like this.
  8. Amw66

    Amw66 Senior Member (Voting Rights)

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    Similar to FND which seems to be going down the tick box symptom list: the fact that many symptoms correlate to other conditions seems lost.
     
    Solstice, Ash, hibiscuswahine and 9 others like this.
  9. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    "...multiple somatic symptoms is associated with higher rates of psychopathology..."

    Here again, was any brain imaging done? My limited understanding is that neurological conditions can cause multiple symptoms.

    It would be interesting to know how many people with neurological conditions of all kinds are just pushed into the BPS category.
    And how long if ever does it take for them to have brain imaging?
     
  10. Cheshire

    Cheshire Moderator Staff Member

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    Thanks Peter.
     
  11. Hutan

    Hutan Moderator Staff Member

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    After the circular thinking, there's this leap in logic. I didn't go back to check, but I don't think multimodal rehabilitation is mentioned until this very last line of the paper (and in the abstract). The results of this study suggest nothing at all about the need for multimodal rehabilitation, unless you believe that the treatment for central sensitisation is multimodal rehabilitation.
     
    Solstice, Missense, Ash and 13 others like this.
  12. rvallee

    rvallee Senior Member (Voting Rights)

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    Betteridge's law of headlines strikes again!
     
    Ash, hibiscuswahine, Sean and 2 others like this.
  13. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    CS is a hypothesis, isn´t it?

    So, why should a hypothesis - which by the way is not worked out in any detailed manner - be a "missing link" to a set of symptoms seen after covid infection?

    One might ask, if symptoms seen after covid infection could be explained by the hypothesis. And yes, it could, only that the hypothesis is not worked out any further and therefore doesn´t provide anything insightful. The question arises:


    Is silliness the missing link to such titles??
     
    Solstice, chrisb, Ash and 6 others like this.
  14. alex3619

    alex3619 Senior Member (Voting Rights)

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    Darn, you stole my line. :) I came here to say exactly the same thing.
     
    Solstice, Ebb Tide, chrisb and 5 others like this.

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