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Impaired psychomotor ability and attention in patients with persistent pain: a cross-sectional comparative study
Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Neron HSU AB, Osby.
Lund University ; Reg Skåne ; Reg Kronoberg.
Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.ORCID iD: 0000-0001-6134-0058
2016 (English)In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 9, p. 825-835Article in journal (Refereed) Published
Abstract [en]

Background and aims: Patients with pain have shown cognitive impairment across various domains. Although the pain qualities vary among patients, research has overlooked how cognitive performance is affected by the duration and persistence of pain. The current study sought to fill this gap by examining how qualitatively different pain states relate to the following cognitive functions: sustained attention, cognitive control, and psychomotor ability. Patients and methods: Patients with musculoskeletal pain in primary care were divided into three pain groups: acute pain (duration <3 months), regularly recurrent pain (duration >3 months), and persistent pain (duration >3 months). These groups were then compared with healthy controls. The MapCog Spectra Test, the Color Word Test, and the Grooved Pegboard Test were used to measure sustained attention, cognitive control, and psychomotor ability, respectively. Results: Patients with persistent pain showed significantly worse sustained attention and psychomotor ability compared with healthy controls. The acute pain group showed a significant decrease in psychomotor ability, and the regularly recurrent pain group showed a significant decrease in sustained attention. These results remained unchanged when age, education, and medication were taken into account. Conclusion: Persistent musculoskeletal pain seems to impair performance on a wider range of cognitive tasks than acute or regularly recurrent pain, using pain-free individuals as a benchmark. However, there is some evidence of impairment in psychomotor ability among patients with acute pain and some impairment in sustained attention among patients with regularly recurrent pain.

Place, publisher, year, edition, pages
2016. Vol. 9, p. 825-835
Keyword [en]
persistent pain, cognitive impairment, musculoskeletal pain, psychomotor ability, attention, cognitive control
National Category
Psychology Neurosciences
Research subject
Social Sciences, Psychology
Identifiers
URN: urn:nbn:se:lnu:diva-59730DOI: 10.2147/JPR.S114915ISI: 000389837700001PubMedID: 27799814Scopus ID: 2-s2.0-84992482345OAI: oai:DiVA.org:lnu-59730DiVA, id: diva2:1063645
Available from: 2017-01-10 Created: 2017-01-10 Last updated: 2018-05-03Bibliographically approved
In thesis
1. The influence of different pain states on pain perception and cognitive functions
Open this publication in new window or tab >>The influence of different pain states on pain perception and cognitive functions
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to investigate the effect of different pain stateson pain perception and cognition.In the first study, the effect of different pain qualities (duration, persistence, andintensity) on deep pressure pain thresholds in a pain-free body part among patientswith acute pain, long-lasting regularly recurrent pain, and long-lasting persistentpain, and pain-free controls was investigated. Such general deep pressure painthresholds were only significantly lower in the group with long-lasting persistentpain when compared to the healthy controls, suggesting that deep tissuehypersensitivity primarily occurs in patients with long-lasting, persistent pain.In the second study, the relationship between the same pain qualities and cognitiveperformance in the form of sustained attention, cognitive control, and psychomotorability was investigated. Overall, patients with long-lasting, persistent pain showedcognitive impairment on a wider range of cognitive tasks compared to patients withacute or long-lasting, regularly recurrent pain, using pain free controls asbenchmark. The results further suggest that persistence and duration, rather thanpain intensity, contribute to impaired cognitive function in clinical musculoskeletalpain states.In the third study, the effect of acute, experimental pain on abstraction wasexamined in a laboratory experiment where pain was induced with a cold pressorapparatus. The results were consistent with the null hypothesis, suggesting thatabstraction is immune to acute, experimental pain.In the fourth study, the correlation between clinical pain, abstraction and selfcontrolwas examined in patients suffering from musculoskeletal pain of differentduration, persistence and intensity. The results suggest that abstract thinking isreduced with increasing pain intensity and pain persistence. This was also the casefor self-control, although depression seems to mediate this relationship.In conclusion, compared to other pain states, patients who experience long-term,persistent pain, seem to suffer from a broader range of impaired cognitive abilities.Further, deep tissue hypersensitivity seems to develop in patients with long-termpersistent pain, but not in other pain states, which may contribute to the impairedcognitive performance observed in this patient group. The results have importantpractical implications for patients in the clinic and their everyday lives.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2018
Series
Linnaeus University Dissertations ; 323/2018
Keyword
Persistent pain, Musculoskeletal pain, Cognitive impairment, Abstraction, Pain Thresholds
National Category
Psychology (excluding Applied Psychology)
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-73789 (URN)978-91-88761-65-1 (ISBN)978-91-88761-64-4 (ISBN)
Public defence
2018-06-15, Myrdal, Hus K, äxjö, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-05-03 Created: 2018-05-03 Last updated: 2018-05-03Bibliographically approved

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