The development of a novel questionnaire assessing alterations in central pain processing in people with and without chronic pain

2020 ◽  
Vol 20 (2) ◽  
pp. 407-417
Author(s):  
Philip D. Austin ◽  
Ali Asghari ◽  
Daniel S.J. Costa ◽  
Philip J. Siddall
Keyword(s):  
Chronic Pain ◽  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Pain Modulation ◽  
Self Report ◽  
Pain Processing ◽  
Central Pain ◽  
Item Questionnaire ◽  
Excellent Internal Consistency ◽  
Central Pain Processing

AbstractBackground and aimsThe purpose of this study was to (a) develop and (b) conduct exploratory factor analysis on a novel self-report instrument for symptoms associated with altered central pain processing.MethodsWe first developed a 25-item questionnaire based on previous literature identifying symptoms and behaviours that may reflect altered spinal and supraspinal pain processing. We then administered this questionnaire to 183 people with chronic pain (n = 99) and healthy individuals (n = 84). Exploratory factor analysis was conducted to identify the factor structure of the questionnaire.ResultsOur results support a two-factor solution for the 25-item questionnaire that accounted for 57.2% of the total variance of responses in people with and without chronic pain. Factor one (11 items) included items related to alterations in sensation of pain, while factor two (seven items) included items associated with emotional and fatigue symptoms. Seven items showed weak factor loadings and were eliminated. Reliability was excellent, while both factors showed strong correlations with previously-validated self-report Instruments: (pain catastrophising, mood, vigilance, pain self-efficacy) and conditioned pain modulation, providing evidence for their validity.ConclusionsWe have developed a questionnaire containing two factors that appear to be related to two different symptom clusters, one of which is specifically related to pain and one of which contains other health-related symptoms related to mood and fatigue. These factors show excellent internal consistency and validity. This questionnaire may be a quick, easy and reliable instrument to assess central pain processing in clinical settings.

scholarly journals Chronic Pain in Inflammatory Arthritis: Mechanisms, Metrology, and Emerging Targets—A Focus on the JAK-STAT Pathway

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Fausto Salaffi ◽  
Giovanni Giacobazzi ◽  
Marco Di Carlo
Keyword(s):  
Central Nervous System ◽  
Chronic Pain ◽  
Inflammatory Arthritis ◽  
Inflammatory Process ◽  
Pain Processing ◽  
Central Pain ◽  
The Central Nervous System ◽  
Central Pain Processing ◽  
Processing Mechanisms ◽  
Stat Pathway

Chronic pain is nowadays considered not only the mainstay symptom of rheumatic diseases but also “a disease itself.” Pain is a multidimensional phenomenon, and in inflammatory arthritis, it derives from multiple mechanisms, involving both synovitis (release of a great number of cytokines) and peripheral and central pain-processing mechanisms (sensitization). In the last years, the JAK-STAT pathway has been recognized as a pivotal component both in the inflammatory process and in pain amplification in the central nervous system. This paper provides a summary on pain in inflammatory arthritis, from pathogenesis to clinimetric instruments and treatment, with a focus on the JAK-STAT pathway.

The effect of one dry needling session on pain, central pain processing, muscle co-contraction and gait characteristics in patients with knee osteoarthritis: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sophie Vervullens ◽  
Lotte Meert ◽  
Isabel Baert ◽  
Nicolas Delrue ◽  
Christiaan H. W. Heusdens ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Pain Modulation ◽  
Group Differences ◽  
Conditioned Pain Modulation ◽  
Pain Processing ◽  
Central Pain ◽  
Dry Needling ◽  
Spatiotemporal Parameters ◽  
Central Pain Processing

Abstract Objectives To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and spatiotemporal parameters during gait in knee osteoarthritis patients. Methods A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences. Results No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling. Conclusions Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.

scholarly journals Does Acetaminophen Activate Endogenous Pain Inhibition in Chronic Fatigue Syndrome/ Fibromyalgia and Rheumatoid Arthritis? A DoubleBlind Randomized Controlled Cross-over Trial

2013 ◽  
Vol 2;16 (2;3) ◽  
pp. E61-E70 ◽  
Author(s):  
Mira Meeus
Keyword(s):  
Temporal Summation ◽  
Chronic Fatigue ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Pain Processing ◽  
Central Pain ◽  
Healthy Controls ◽  
Fatigue Syndrome ◽  
Central Pain Processing ◽  
Pain Inhibition

Background: Although enhanced temporal summation (TS) and conditioned pain modulation (CPM), as characteristic for central sensitization, has been proved to be impaired in different chronic pain populations, the exact nature is still unknown. Objectives: We examined differences in TS and CPM in 2 chronic pain populations, patients with both chronic fatigue syndrome (CFS) and comorbid fibromyalgia (FM) and patients with rheumatoid arthritis (RA), and in sedentary, healthy controls, and evaluated whether activation of serotonergic descending pathways by acetaminophen improves central pain processing. Study Design: Double-blind randomized controlled trial with cross-over design. Methods: Fifty-three women (19 CFS/FM patients, 16 RA patients, and 18 healthy women) were randomly allocated to the experimental group (1 g acetaminophen) or the placebo group (1 g dextrose). Participants underwent an assessment of endogenous pain inhibition, consisting of an evaluation of temporal summation with and without conditioned pain modulation (CPM). Seven days later groups were crossed-over. Patients and assessors were blinded for the allocation. Results: After intake of acetaminophen, pain thresholds increased slightly in CFS/FM patients, and decreased in the RA and the control group. Temporal summation was reduced in the 3 groups and CPM at the shoulder was better overall, however only statistically significant for the RA group. Healthy controls showed improved CPM for both finger and shoulder after acetaminophen, although not significant. Limitations: The influence of acetaminophen on pain processing is inconsistent, especially in the patient groups examined. Conclusion: This is the first study comparing the influence of acetaminophen on central pain processing in healthy controls and patients with CFS/FM and RA. It seems that CFS/ FM patients present more central pain processing abnormalities than RA patients, and that acetaminophen may have a limited positive effect on central pain inhibition, but other contributors have to be identified and evaluated. Key words: Chronic pain, sensitization, acetaminophen, conditioned pain modulation, temporal summation, chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis

scholarly journals Altered central pain processing in fibromyalgia – a multimodal neuroimaging case-control study using arterial spin labelling

2020 ◽  
Author(s):  
Monika Müller ◽  
Florian Wüthrich ◽  
Andrea Federspiel ◽  
Roland Wiest ◽  
Niklaus Egloff ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Resting State ◽  
Case Control Study ◽  
Case Control ◽  
Pain Processing ◽  
Central Pain ◽  
Brain Areas ◽  
Structural Alterations ◽  
Central Pain Processing ◽  
Control Study

AbstractFibromyalgia is characterized by chronic pain and a striking discrepancy between objective signs of tissue damage and severity of pain. Function and structural alterations in brain areas involved in pain processing may explain this feature. Previous case-control studies in fibromyalgia focused on acute pain processing using experimentally-evoked pain paradigms. Yet, these studies do not allow conclusions about chronic, stimulus-independent pain. Resting-state cerebral blood flow (rsCBF) acquired by arterial spin labelling (ASL) may be a more accurate marker for chronic pain. The objective was to integrate four different functional and structural neuroimaging markers to evaluate the neural correlate of chronic, stimulus-independent pain using a resting-state paradigm. In line with the pathophysiological concept of enhanced central pain processing we hypothesized that rsCBF is increased in fibromyalgia in areas involved in processing of acute pain.We performed an age matched case-control study of 32 female fibromyalgia patients and 32 pain-free controls and calculated group-differences in rsCBF, resting state functional connectivity, grey matter density and cortical thickness using whole-brain and region of interest analyses. We adjusted all analyses for depression and anxiety. As centrally acting drugs are likely to interfere with neuroimaging markers, we performed a subgroup analysis limited to patients not taking such drugs.We found no differences between cases and control in rsCBF of the thalamus, the basal ganglia, the insula, the somatosensory cortex, the prefrontal cortex, the anterior cingulum and supplementary motor area as brain previously identified to be involved in acute processing in fibromyalgia. The results remained robust across all four neuroimaging markers and when limiting the study population to patients not taking centrally acting drugs and matched controls.In conclusion, we found no evidence for functional or structural alterations in brain areas involved in pain processing in fibromyalgia that could reflect neural correlates of chronic stimulus-independent pain.

Measuring Impact of Stress in Sandwich Generation Caring for Demented Parents

GeroPsych ◽  
2014 ◽  
Vol 27 (4) ◽  
pp. 171-179 ◽  
Author(s):  
Laurence M. Solberg ◽  
Lauren B. Solberg ◽  
Emily N. Peterson
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Social Worker ◽  
Resource Availability ◽  
Well Being ◽  
Sandwich Generation ◽  
Item Questionnaire ◽  
Significant Difference ◽  
Adult Caregivers ◽  
The Impact

Stress in caregivers may affect the healthcare recipients receive. We examined the impact of stress experienced by 45 adult caregivers of their elderly demented parents. The participants completed a 32-item questionnaire about the impact of experienced stress. The questionnaire also asked about interventions that might help to reduce the impact of stress. After exploratory factor analysis, we reduced the 32-item questionnaire to 13 items. Results indicated that caregivers experienced stress, anxiety, and sadness. Also, emotional, but not financial or professional, well-being was significantly impacted. There was no significant difference between the impact of caregiver stress on members from the sandwich generation and those from the nonsandwich generation. Meeting with a social worker for resource availability was identified most frequently as a potentially helpful intervention for coping with the impact of stress.

Treatment response and central pain processing in Anterior Cutaneous Nerve Entrapment Syndrome: An explorative study

2017 ◽  
Vol 14 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Dagmar C. van Rijckevorsel ◽  
Oliver B. Boelens ◽  
Rudi M. Roumen ◽  
Oliver H. Wilder-Smith ◽  
Harry van Goor
Keyword(s):  
Abdominal Wall ◽  
Nerve Entrapment ◽  
Cutaneous Nerve ◽  
Diagnosis And Treatment ◽  
Pain Processing ◽  
Central Pain ◽  
Pain Thresholds ◽  
Generalized Hyperalgesia ◽  
Central Pain Processing ◽  
Nerve Entrapment Syndrome

AbstractBackground10–30% of chronic abdominal pain originates in the abdominal wall. A common cause for chronic abdominal wall pain is the Anterior Cutaneous Nerve Entrapment Syndrome (ACNES), in which an intercostal nerve branch is entrapped in the abdominal rectus sheath. Treatment consists of local anaesthetics and neurectomy, and is ineffective in 25% of cases for yet unknown reasons.In some conditions, chronic pain is the result of altered pain processing. This so-called sensitization can manifest as segmental or even generalized hyperalgesia, and is generally difficult to treat.ObjectiveThe aim of this study was to assess pain processing in ACNES patients responsive and refractory to treatment by using Quantitative Sensory Testing, in order to explore whether signs of altered central pain processing are present in ACNES and are a possible explanation for poor treatment outcomes.Methods50 patients treated for ACNES with locally orientated treatment were included. They were allocated to a responsive or refractory group based on their response to treatment. Patients showing an improvement of the Visual Analogue Scale (VAS) pain score combined with a current absolute VAS of <40 mm were scored as responsive.Sensation and pain thresholds to pressure and electric skin stimulation were determined in the paravertebral bilateral ACNES dermatomes and at four control areas on the non-dominant side of the body, i.e. the musculus trapezius pars medialis, musculus rectus femoris, musculus abductor hallucis and the thenar. The ACNES dermatomes were chosen to signal segmental hyperalgesia and the sum of the control areas together as a reflection of generalized hyperalgesia. Lower thresholds were interpreted as signs of sensitized pain processing. To test for alterations in endogenous pain inhibition, a conditioned pain modulation (CPM) response to a cold pressor task was determined. Also, patients filled in three pain-related questionnaires, to evaluate possible influence of psychological characteristics on the experienced pain.ResultsPatients refractory to treatment showed significantly lower pressure pain thresholds in the ACNES dermatomes and for the sum of as well as in two individual control areas. No differences were found between groups for electric thresholds or CPM response. Duration of complaints before diagnosis and treatment was significantly longer in the refractory compared to the responsive group, and refractory patients scored higher on the pain-related psychological surveys.Conclusion and ImplicationsIn this hypothesis-generating exploratory study, ACNES patients refractory to treatment showed more signs of sensitized segmental and central pain processing. A longer duration of complaints before diagnosis and treatment may be related to these alterations in pain processing, and both findings could be associated with less effective locally orientated treatment. In order to validate these hypotheses further research is needed.Registration numberNCT01920880 (Clinical Trials Register; http://www.clinicaltrials.gov).

Pain outcome after pancreatic surgery for pain of chronic pancreatitis: Relation to altered central pain processing

Pancreatology ◽  
2013 ◽  
Vol 13 (2) ◽  
pp. e7
Author(s):  
S.A.W. Bouwense ◽  
U.A. Ali ◽  
R.P.G. ten Broek ◽  
Y. Issa ◽  
C.H. van Eijck ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Surgery ◽  
Pain Processing ◽  
Central Pain ◽  
Pain Outcome ◽  
Central Pain Processing

scholarly journals Οικογενειακοί-σχολικοί παράγοντες που σχετίζονται με τα προβλήματα συμπεριφοράς μαθητών δημοτικού σχολείου και η διαχείρισή τους στο πλαίσιο της οικογένειας και του σχολείου

2015 ◽  
Author(s):  
Μαρία Σμυρνάκη
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Path Analysis ◽  
Exploratory Factor Analysis ◽  
Short Form ◽  
Self Report ◽  
Parental Acceptance ◽  
Confirmatory Factor ◽  
Path Models

Σκοπός της παρούσας μελέτης ήταν η διερεύνηση οικογενειακών και σχολικών παραγόντων που σχετίζονται με τα προβλήματα συμπεριφοράς μαθητών δημοτικού σχολείου και των πρακτικών διαχείρισής τους στο πλαίσιο της οικογένειας και του σχολείου στην ημιαστική περιοχή του Γαζίου, του Νομού Ηρακλείου Κρήτης. Ειδικότερα, επρόκειτο για μια μελέτη περίπτωσης που βασίστηκε στη συλλογή εμπειρικών και ποιοτικών δεδομένων. Στο εμπειρικό της μέρος, πραγματοποιήθηκε συγκριτική έρευνα ανάμεσα σε 55 μαθητές με προβλήματα συμπεριφοράς (ερευνητική ομάδα) και σε 55 μαθητές χωρίς προβλήματα συμπεριφοράς (ομάδα ελέγχου), που ανήκαν στις τρεις τελευταίες τάξεις του δημοτικού σχολείου, με τη χορήγηση 7 συνολικά ερωτηματολογίων: 1) Ερωτηματολόγιο TRF για Εκπαιδευτικούς (32 Ερωτήσεις) Παιδιών Ηλικίας 6-18 ετών (Achenbach & Rescorla, 2003), 2) Εργαλείο Ψυχοκοινωνικής Προσαρμογής: Κλίμακα Αυτοαναφοράς για Μαθητές 10-12 ετών (Χατζηχρήστου, Πολυχρόνη, Μπεζεβέγκης, & Μυλωνάς, 2008), 3) Εργαλείο Ψυχοκοινωνικής Προσαρμογής: Κλίμακα Εκπαιδευτικού για Παιδιά 7-12 ετών (Χατζηχρήστου, Πολυχρόνη, Μπεζεβέγκης, & Μυλωνάς, 2008), 4) PARQ/Parental Acceptance-Rejection/Short Form (Rohner, 2004), 5) TARQ/Teacher’s Acceptance-Rejection/Short Form (Rohner, 2004), 6) SFI/Self Report Family Inventory, Version II (Beavers & Hampson, 1990) και 7) Το Ερωτηματολόγιο της Τάξης μου για το Δημοτικό Σχολείο (ΤΕΤ/Βούλγαρης & Ματσαγγούρας, 2004). Το ποιοτικό μέρος περιελάμβανε τη μελέτη 12 συνολικά περιπτώσεων μαθητών με προβλήματα συμπεριφοράς και τη διεξαγωγή ημιδομημένων συνεντεύξεων στους ίδιους τους μαθητές, στους γονείς και στους δασκάλους τους (36 συνολικά συνεντεύξεις), όπου κατά κύριο λόγο διερευνήθηκαν: οι πρακτικές διαχείρισης που υιοθετούνται από τους γονείς και τους δασκάλους απέναντι στα προβλήματα συμπεριφοράς των μαθητών, ο τρόπος που αυτές βιώνονται από τους μαθητές, οι αντιδράσεις που τους προκαλούν και η αποτίμηση της αποτελεσματικότητάς τους κι από τις τρεις πλευρές. Η ανάλυση των εμπειρικών δεδομένων της έρευνας, η οποία βασίστηκε στο Στατιστικό Πακέτο IBM SPSS Statistics Version 20, περιελάμβανε Διμεταβλητές Σχέσεις, Διερευνητική Παραγοντική Ανάλυση/Exploratory Factor Analysis (EFA), Επιβεβαιωτική Παραγοντική Ανάλυση /Confirmatory Factor Analysis (CFA) και Ανάλυση Διαδρομών/Path Analysis, όπου εξετάστηκε η προσαρμογή 9 διαφορετικών Μοντέλων Διαδρομών/Path Models. Οι συνεντεύξεις της ποιοτικής μελέτης αναλύθηκαν με τη μέθοδο της ανάλυσης περιεχομένου. Σύμφωνα με τα βασικότερα ευρήματα του εμπειρικού μέρους: 1) η αυτοαντίληψη του μαθητή διαδραματίζει τον πιο σημαντικό ρόλο στην πρόβλεψη των προβλημάτων συμπεριφοράς στο συγκεκριμένο πληθυσμό μαθητών, συγκρινόμενη τους άλλους παράγοντες ψυχοκοινωνικής του ανάπτυξης (κοινωνική, συναισθηματική και σχολική επάρκεια), 2) η εχθρότητα/επιθετικότητα του πατέρα και της μητέρας προβλέπουν σε σημαντικό βαθμό την παρουσία προβλημάτων συμπεριφοράς στον πληθυσμό αυτό, 3) η στάση αποδοχής/απόρριψης των δύο γονιών συνάδει μεταξύ τους, με τη στάση του πατέρα να επηρεάζει τη στάση της μητέρας στις ήπιες μορφές απόρριψης και τη στάση της μητέρας να επηρεάζει τη στάση του πατέρα στις πιο έντονες μορφές απόρριψης, ενώ η αντίστοιχη στάση του δασκάλου επηρεάζεται από τη στάση του πατέρα, 4) η ζεστασιά/στοργή της μητέρας διαδραματίζει τον πιο σημαντικό ρόλο στην πρόβλεψη των προβλημάτων συμπεριφοράς και της σχολικής επάρκειας των μαθητών αυτών, συγκρινόμενη με τις άλλες διαστάσεις μητρικής και πατρικής αποδοχής/απόρριψης, ενώ τόσο η συνοχή, όσο και η σύγκρουση της οικογένειας προβλέπουν με τον ίδιο τρόπο την υγιή/ικανή οικογενειακή λειτουργία και 5) η αδιαφοροποίητη απόρριψη του δασκάλου προβλέπει στο μεγαλύτερο βαθμό την παρουσία προβλημάτων συμπεριφοράς στο συγκεκριμένο πληθυσμό μελέτης συγκριτικά με τις άλλες διαστάσεις αποδοχής/απόρριψης του δασκάλου, ενώ τόσο η συνεκτικότητα, όσο και η διενεκτικότητα της τάξης προβλέπουν με τον ίδιο τρόπο την ικανοποίηση από τη λειτουργία της τάξης. Ακόμα, βάσει των κυριότερων δεδομένων του ποιοτικού μέρους της έρευνας: 1) υπερισχύουν οι αρνητικές γονικές και εκπαιδευτικές πρακτικές αντιμετώπισης της προβληματικής συμπεριφοράς των μαθητών (π.χ. ανέβασμα του τόνου της φωνής, τιμωρίες, φυσική/σωματική επιθετικότητα), σύμφωνα με τις αναφορές των ίδιων των μαθητών, 2) οι πρακτικές των γονιών κι ειδικά της μητέρας βιώνονται από τους μαθητές ως πιο σκληρές από εκείνες των δασκάλων τους και συνήθως συνδέονται με τη μη συμμόρφωσή τους, σε αντιδιαστολή με εκείνες του δασκάλου, στις οποίες οι μαθητές συμμορφώνονται, 3) οι αρνητικές γονικές πρακτικές προκαλούν συναισθήματα στενοχώριας, φόβου και θυμού στους μαθητές, 4) οι αποτελεσματικές γονικές και εκπαιδευτικές πρακτικές ομόφωνα συνδέονται, κατά την αντίληψη των τριών πλευρών, με θετικούς κυρίως τρόπους προσέγγισης των μαθητών (π.χ. συζήτηση, ενθάρρυνση, χιούμορ), ενώ οι αναποτελεσματικές πρακτικές με αποκλειστικά αρνητικούς τρόπους προσέγγισής τους (π.χ. ανέβασμα του τόνου της φωνής, τιμωρία, επίπληξη) και 5) οι μαθητές ζητούν από τους γονείς και τους δασκάλους τους να σταματήσουν τις αρνητικές πρακτικές και να αυξήσουν τις θετικές πρακτικές που εφαρμόζουν. Πρόκειται για δεδομένα που συμβάλλουν σημαντικά στη βαθύτερη κατανόηση του συγκεκριμένου πληθυσμού μελέτης, η οποία συνιστά αναγκαία προϋπόθεση και συνθήκη για το σχεδιασμό και την υλοποίηση εστιασμένων/αποτελεσματικών προληπτικών προγραμμάτων και παρεμβάσεων σχετικά με την προβληματική/αντικοινωνική (επιθετική και παραβατική) συμπεριφορά των προ-εφήβων μαθητών.

A-196 The Texas Postconcussion Symptom Inventory (TPSI): An Exploratory Factor Analysis and Reliability Analysis

2021 ◽  
Vol 36 (6) ◽  
pp. 1251-1251
Author(s):  
Anthony J Longoria ◽  
Ben K Mokhtari ◽  
Tawny Meredith-Duliba ◽  
Mary A Hershberger ◽  
Patricia Champagne ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Internal Consistency ◽  
Clinical Sample ◽  
Somatic Symptoms ◽  
Self Report ◽  
Future Research ◽  
Symptom Inventory ◽  
Multidimensional Measure ◽  
Three Factor

Abstract Objective Self-report scales are commonly used to evaluate non-specific symptoms following concussion. While several scales have been developed, few were created using a systematic process and most contain several ambiguous items that may be misinterpreted. To address this, a new theoretically-based, multidimensional measure was designed to assess Cognitive, Neuropsychiatric, and Somatic symptoms associated with concussion. This study used sophisticated psychometric techniques to develop the Texas Postconcussion Symptom Inventory (TPSI) and establish initial reliability and validity. Method Because concussion symptoms are non-specific, a pool of 76 potential items was developed and administered to a diverse clinical sample (N = 350) that included patients with concussion, epilepsy, and dementia. Polychoric correlations were utilized to remove items based on poor fit/multicollinearity and an exploratory factor analysis (EFA) with an Oblimin rotation was used to determine factor structure. Results A three-factor model best fit the data, and represented Cognitive, Neuropsychiatric, and Somatic domains as designed. Ten items were discarded, resulting in a total of 66 items. The model explained 48.5% of the total variance and contained adequate sampling (Kaiser-Meyer-Olkin measure =0.92) and sufficient item correlations (Bartlett’s Test of Sphericity, p &lt; 0.05) for EFA. All three factor structures displayed high internal consistency (Cronbach’s α &gt; 0.88). Conclusions The TPSI is a brief, multidimensional measure with evidence of strong internal consistency and reliability as well as distinct Cognitive, Neuropsychiatric, and Somatic symptoms associated with concussion. Future research will investigate its convergent and divergent validity in concussion as compared to existing popular symptom measures.

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