School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil.
Eur J Phys Rehabil Med. 2009 Dec;45(4):469-77. Epub 2009 Nov 24.
This study investigates whether chronic low back pain (LBP) and rheumatoid arthritis (RA) patients have deficits in memory functioning and whether there is correlation between memory scores and coping skills, as a disability evaluation measure.
We studied 2 samples of patients of both genders between 20 and 70 years-old, in a cross-sectional design: 21 low back pain and 23 rheumatoid arthritis. Patients were compared to historical controls. Assessment of primary outcome included memory evaluation (Wechsler Memory Scale III) and measures of coping strategies (FABQ, CPCI, CSQ). Other data included depression (HAD), pain (VAS), work status, use of medications, and perceived memory complaints. Analysis were made of between-group differences.
Both groups were comparable regarding demographic status, had high scores of memory complaint, and low performance in memory assessment when compared to normative data. Only LBP patient's measures of catastrophizing and coping were significantly correlated to late memory indices. No correlations were found between memory and Visual Analogue Scale (VAS) or pain chronicity in both groups. One may suggest that both chronic localized and widespread pain can imply in cognitive changes and be correlated to coping dysfunction. However, bias of existence of depression/ anxiety and psychotropic medication cannot be excluded.
Both groups of chronic pain patients are likely to have impaired memory. Maladaptive coping correlates to LBP, but not to RA. A further controlled protocol must include greater sample of patients. By analyzing memory deficits of chronic pain patients, clinicians could establish targeted rehabilitation programs and outcomes. Some techniques are discussed.
本研究旨在调查慢性下背痛（LBP）和类风湿关节炎（RA）患者是否存在记忆功能障碍，以及记忆评分与作为残疾评估指标的应对技能之间是否存在相关性。
我们采用横断面设计研究了两个性别在 20 至 70 岁之间的患者样本：21 例 LBP 和 23 例 RA。将患者与历史对照进行比较。主要结局评估包括记忆评估（韦氏记忆量表 III）和应对策略评估（FABQ、CPCI、CSQ）。其他数据包括抑郁（HAD）、疼痛（VAS）、工作状态、药物使用和感知记忆抱怨。进行了组间差异分析。
两组在人口统计学状况方面具有可比性，与正常数据相比，两组患者的记忆抱怨评分较高，记忆评估得分较低。只有 LBP 患者的灾难化和应对措施测量与晚期记忆指数显著相关。在两组中，均未发现记忆与视觉模拟量表（VAS）或疼痛持续时间之间存在相关性。这可能表明，慢性局部和广泛疼痛都会导致认知变化，并与应对功能障碍相关。然而，不能排除存在抑郁/焦虑和精神药物的偏倚。
两组慢性疼痛患者都可能存在记忆障碍。适应性应对与 LBP 相关，但与 RA 无关。进一步的对照方案必须包括更多的患者样本。通过分析慢性疼痛患者的记忆缺陷，临床医生可以制定有针对性的康复计划和结果。讨论了一些技术。
