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前瞻性研究健康成年人在轻度创伤性脑损伤后的疼痛类型、认知和抱怨之间的关联。

The association between pain type, cognition and complaint after mild traumatic brain injury in prospectively studied premorbidly healthy adults admitted to hospital.

机构信息

Melbourne School of Psychological Sciences.

出版信息

Neuropsychology. 2020 Jan;34(1):53-62. doi: 10.1037/neu0000585. Epub 2019 Jul 25.

Abstract

OBJECTIVE

Literature examining the relationship between pain, cognition, and complaint after mild traumatic brain injury (mTBI) has conceptualized and measured pain as a unitary construct. Pain is defined as being multidimensional, however, with both sensory and affective aspects. The current study aimed to determine whether the sensory and affective aspects of pain differentially relate to cognition and complaint.

METHOD

Using a prospective observational design, 6-10 weeks after injury, we assessed 60 premorbidly healthy individuals, who were admitted to hospital after an mTBI. Participants were assessed with multidimensional and unitary pain questionnaires, as well as measures of cognition, complaint, anxiety and depression.

RESULTS

Findings showed that a univariate measure of pain did not successfully measure affective pain. Multidimensional pain assessment revealed that affective descriptors of pain were significantly and independently associated with aspects of cognitive function (p < .05). A number of sensory types of pain also significantly related to cognition (p < .05), with these relationships varying between the different sensory pain types. Continuous type sensory pain also independently predicted memory and executive function. No independent linear relationships were evident between any type of pain and level of complaint.

CONCLUSIONS

These findings show for the first time that it is important to examine both affective and sensory aspects of pain in individuals after mTBI, as pain subtypes show differential relationships with cognition. The study also suggests that the relationship between pain and complaint is not an independent one. This study has implications for treatment and management of individuals experiencing cognitive difficulties after mTBI. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

摘要

目的

研究轻度创伤性脑损伤(mTBI)后疼痛、认知和抱怨之间关系的文献将疼痛概念化为单一结构。然而,疼痛是多维度的,具有感觉和情感两个方面。本研究旨在确定疼痛的感觉和情感方面是否与认知和抱怨存在差异。

方法

采用前瞻性观察设计,在损伤后 6-10 周,我们评估了 60 名受伤前健康的个体,他们因 mTBI 住院。参与者接受了多维和单一疼痛问卷以及认知、抱怨、焦虑和抑郁测量。

结果

研究结果表明,疼痛的单变量测量不能成功测量情感疼痛。多维疼痛评估显示,疼痛的情感描述与认知功能的各个方面显著且独立相关(p<.05)。几种类型的感觉疼痛也与认知显著相关(p<.05),这些关系在不同的感觉疼痛类型之间有所不同。连续型感觉疼痛也独立预测了记忆和执行功能。任何类型的疼痛与抱怨水平之间均无明显的线性关系。

结论

这些发现首次表明,在 mTBI 后个体中,检查疼痛的情感和感觉方面很重要,因为疼痛亚型与认知存在不同的关系。该研究还表明,疼痛与抱怨之间的关系不是独立的。本研究对治疗和管理 mTBI 后出现认知困难的个体具有重要意义。(PsycINFO 数据库记录(c)2020 APA,保留所有权利)。

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