Central Sensitization Severity in Chronic Low Back Pain: Associations with Sleep, Distress, Cortisol, and Visuospatial Working Memory

Severe central sensitization in CLBP is associated with poor sleep, increased emotional distress, elevated morning cortisol, and deficits in visuospatial working memory, even in the absence of clear differences in IL-6 or fasting glucose. These findings support a biopsychosocial profile characterized by both neuroendocrine and cognitive alterations in patients with high levels of CS and highlight potential targets for multimodal assessment and intervention.