The Relationship Between Chronic Pain and Neurocognitive Function

Higgins, Diana M.; Martin, Aaron M.; Baker, Dewleen G.; Vasterling, Jennifer J.; Risbrough, Victoria B.

doi:10.1097/ajp.0000000000000536

Cited by 97 publications

(95 citation statements)

References 70 publications

(93 reference statements)

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“…As remarked in previous work, CP itself is commonly associated with factors such as depression, anxiety, fatigue, reduction of quality of life, and disability . These psychological consequences of CP may impair cognitive functioning more than opioid treatment, which conversely may improve some aspects of neurocognition in patients, likely via reduced pain and related affective distress …”

Section: Discussionmentioning

confidence: 80%

“…42 These psychological consequences of CP may impair cognitive functioning more than opioid treatment, which conversely may improve some aspects of neurocognition in patients, likely via reduced pain and related affective distress. 37 Pain is a subjective experience, and several psychological factors contribute to the relationship between pain and cognitive complaints. 16 This can be affected by pain perception and by the outcomes of treatments, activating the brain system of opioid-related pain relief 12 and modifying the subjective effects of opioids treatments.…”

Section: Methodological Considerations About the Papers Analyzedmentioning

confidence: 99%

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Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain

et al. 2018

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Background and Objective Opioid treatments are often prolonged because of the pathology causing pain. We focused on the cognitive functions in patients with chronic pain treated with opioids. This topic is currently controversial, but in practice, the consequences are important in patients’ daily lives, social interactions, working ability, and driving. Database and Data Treatment Medline and Embase databases were searched for eligible articles. We included studies that enrolled patients with chronic noncancer pain, studies with patients receiving opioid treatment, studies with a control group not using opioids, and studies in which cognitive functions were evaluated with specific tests. The cognitive areas examined were as follows: attention, reaction time, executive functions, psychomotor speed, memory, and working memory. From 356 abstracts screened, 9 articles satisfied eligibility criteria and were included in our review: 7 observational and 7 experimental studies. We classified the pain treatments as follows: opioids, other drugs active on the central nervous system (CNS) (antidepressants/anticonvulsants), and treatments not specifically targeted to the CNS. Results Statistically significant differences were seen only with regard to attention between opioids alone and no centrally acting treatment (standardized mean difference [SMD]: −0.53, 95% confidence interval [CI] : −0.91, −0.15; P = 0.007; I2 = 23%) and between opioids combined with antidepressants and/or anticonvulsants and no centrally acting treatment (SMD: −0.62, 95% CI: −1.04, −0.20; P = 0.004; I2 = 0%). No other significant differences were observed. Conclusions Opioids reduce attention when compared with treatments not targeted on the CNS. If opioids are used together with antidepressants and/or anticonvulsants, this effect increases. Significance These findings on the neuropsychological effects of opioids could be used to generate strategies to refine pain treatments.

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Section: Discussionmentioning

confidence: 80%

Section: Methodological Considerations About the Papers Analyzedmentioning

confidence: 99%

Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain

et al. 2018

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“…Data from our study are consistent with those of clinical studies showing that pain, associated with surgery, could contribute to the development of postoperative cognitive dysfunction (POCD). For example, in a population aged 65 years or older (Wang et al 2007) and could impair neurocognitive performance in chronic pain simples (reviewed by Higgins et al 2018). Furthermore, Zywiel et al, in a systematic review, concluded that both anesthetic and pain management strategies do appear to affect the risk of POCD in patients enduring elective joint arthroplasty (Zywiel et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Postoperative cognitive recovery in children after both general and locoregional anesthesia and surgery

Hammoumi

Dahchour

Chhiti

et al. 2020

Preprint

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Background and objectivesRecent researches have demonstrated that there is a progressive impairment in neurocognitive function following general anesthesia and surgery, and particularly, have evidenced that anesthetics impaired mechanisms of learning and memory, for days to months, in both adults and children.This study aimed to evaluate the influence of different types of anesthesia (General or Locoregional) on cognitive recovery by trial and error method, and also take into consideration other factors that would have an impact on the cognitive performance after anesthesia and surgery in children.MethodsIn the present cross-sectional study, 64 young children, aged between 10 and 15 years, have passed the CALM test (software based on trial and error method) 24h after their surgery, and the operating file filled by the anesthetist. The statistical analysis includes a descriptive part of our sample, a univariate, and multivariate analysis of the results of the CALM test and the various medical factors and lifestyles.Results and conclusionsThe cognitive performance of patients exposed to locoregional anesthesia (81.3%) was higher (p=0.01) when compared to patients under general anesthesia (34.4%). Both agitation (Neurological state) and postoperative pain significantly (p=0.02) altered the cognitive performance of patients. However, none of the other factors assessed such as gender, environmental living, schooling, pre-anesthetic consultation, and the type of intervention affects the postoperative cognitive performance of patients.Locoregional anesthesia has less effect on cognitive recovery when compared to general anesthesia. Both the postoperative pain and agitation alter cognitive performances of operated children.

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“…Due to missing MRI measurements and missing matching partners, we excluded 8 participants in each group. The demographic, clinical, and neuropsychological characteristics of the chronic pain group (n = 34) and the individually matched 3 106 ± 9 97 ± 9 > 0.001 (t-test) Depression score 4 5 ± 4 16 ± 10 > 0.001 (t-test) Table 1. Demographic, clinical, and neuropsychological data of healthy controls and patients with chronic pain.…”

Section: Diffusion Tensor Imaging In the Chropain1 Studymentioning

confidence: 99%

“…Chronic pain is a major medical, social, and economical problem, causing a significant individual and societal burden worldwide (1,2). Chronic pain is often associated with cognitive (3)(4)(5) and emotional (6,7) disturbances and also has serious consequences for social relationships, work, and the individual's family (8). The prevalence of moderate-tosevere chronic noncancer pain in the adult population ranges between 10% and 20% in developed countries (9,10).…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging of white matter microstructure in chronic pain: a tract-based spatial statistics study and a systematic review

Koch

Bantel

et al. 2020

Preprint

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The pathophysiology of many chronic pain disorders is far from evident. MR imaging studies provided initial data indicating chronic pain might lead to changes in brain structure and function. These changes may contribute to cognitive and emotional impairment and maybe even to the chronification of pain. However, the evidence for pain-related changes in gray and white matter is inconclusive so far. Hence we investigated potential changes of white matter microstructure in 34 adults with chronic noncancer pain (> 1 year) and 34 sex- and age-matched healthy individuals using diffusion tensor imaging (DTI). Whole-brain tract-based spatial statistics (TBSS) analyses of fractional anisotropy, mode of diffusivity, mean diffusivity, axial diffusivity, and radial diffusivity did not show significant differences after correction for multiple comparisons. The volumes of subdivisons of the corpus callosum were not significantly different either. We also performed a systematic review of the existing literature on white matter microstructure in patients with chronic pain following PRISMA guidelines. We identified 53 eligible studies on DTI in chronic pain. These studies demonstrated conflicting results regarding the direction and location of white matter changes across all diagnoses and within major diagnostic subcategories. We propose that two factors primarily contribute to this low reproducibility, small sample size and the use of potentially unreliable DTI parameters derived from the single-tensor model.

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The Relationship Between Chronic Pain and Neurocognitive Function

Cited by 97 publications

References 70 publications

Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain

Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain

Postoperative cognitive recovery in children after both general and locoregional anesthesia and surgery

Diffusion tensor imaging of white matter microstructure in chronic pain: a tract-based spatial statistics study and a systematic review

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