Moore David J, Meints Samantha M, Lazaridou Asimina, Johnson Devin, Franceschelli Olivia, Cornelius Marise, Schreiber Kristin, Edwards Robert R
School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK.
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Pain. 2019 Nov;20(11):1353-1361. doi: 10.1016/j.jpain.2019.05.004. Epub 2019 May 9.
Pain has well-established effects on attention. At present, parallel literatures exist that have examined the effects of experimentally induced pain and consider cognitive performance in patients with chronic pain states. However, no study to date as attempted to examine the combined or differing effects of these 2 manifestations of pain in a single study. Twenty-four participants with fibromyalgia (aged 43.00 ± 28.28 years) and 26 healthy controls (aged 36.07 ± 11.93 years) completed an n-back task, an attentional switching task, and a divided attention task, once during induced, moderately intense pressure pain, and once without induced pain. Pain induction had selective effects on the n-back task and an overall decrease in accuracy on the attentional switching task. Conversely, patients with fibromyalgia were selectively impaired in performance on the divided attention task. These data therefore suggest that the effects of pain are not summative and rather that the mechanisms that underlie the negative effects of pain on performance in acute and chronic states may differ. More research is needed to examine these mechanisms and how these negative effects can be ameliorated to treat cognitive symptoms in pain. PERSPECTIVE: This article presents a study to examine the effects of an acute, induced pain model on cognitive performance in both patients with fibromyalgia and healthy control populations. We established that the effects of acute and chronic pain on attention are different, suggesting that different models need to be developed to understand these phenomena.
疼痛对注意力有着确凿的影响。目前,存在着平行的文献,它们研究了实验性诱发疼痛的影响,并考量了慢性疼痛状态患者的认知表现。然而,迄今为止,尚无研究尝试在一项单独的研究中检验这两种疼痛表现形式的综合或不同影响。24名纤维肌痛患者(年龄43.00 ± 28.28岁)和26名健康对照者(年龄36.07 ± 11.93岁)完成了一项n-back任务、一项注意力转换任务和一项分散注意力任务,一次是在诱发的中度强烈压力疼痛期间,一次是在无诱发疼痛时。疼痛诱发对n-back任务有选择性影响,且在注意力转换任务上准确性总体下降。相反,纤维肌痛患者在分散注意力任务的表现上存在选择性受损。因此,这些数据表明疼痛的影响并非累加性的,而是疼痛在急性和慢性状态下对表现产生负面影响的潜在机制可能有所不同。需要更多研究来检验这些机制以及如何减轻这些负面影响以治疗疼痛中的认知症状。观点:本文呈现了一项研究,以检验急性诱发疼痛模型对纤维肌痛患者和健康对照人群认知表现的影响。我们确定了急性和慢性疼痛对注意力的影响不同,这表明需要开发不同的模型来理解这些现象。