Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Eur J Pain. 2019 Oct;23(9):1608-1618. doi: 10.1002/ejp.1437. Epub 2019 Jul 29.
Effects from cognitive performance on pain tolerance have been documented, however, sample sizes are small and confounders often overlooked. We aimed to establish that performance on neuropsychological tests was associated with pain tolerance, controlling for salient confounders.
This was a cross-sectional study nested within the Tromsø-6 survey. Neuropsychological test performance and the cold pressor test were investigated in 4,623 participants. Due to significant interaction with age, participants were divided into three age groups (<60, ≥60 to <70 and ≥70 years). Cox proportional hazard models assessed the relationship between neuropsychological tests and cold pressure pain tolerance, using hand-withdrawal as event. The fully adjusted models controlled for sex, education, BMI, smoking status, exercise, systolic blood pressure, sleep problems and mental distress.
In the adjusted models, participants aged ≥70 years showed a decreased hazard of hand withdrawal of 18% (HR 0.82, 95% CI (0.73, 0.92) per standard deviation on immediate verbal recall, and a decreased hazard of 23% (HR 0.77, 95% CI (0.65, 0.08) per standard deviation on psychomotor speed. Participants aged ≥60 to <70 years had a significant decreased hazard of 11% (HR 0.89, 95% CI (0.80, 0.98) per standard deviation on immediate word recall. In participants aged <60 years, there was a decreased hazard of 14% (HR 0.86 95% CI: 0.76, 0.98), per standard deviation on psychomotor speed.
Better performance on neuropsychological tests increased pain tolerance on the cold pressor test. These exposure effects were present in all age groups.
This paper describes substantial associations between cognitive functioning and cold pressor tolerance in 4,623 participants. Reduced psychomotor speed and poor verbal recall gave greater odds for hand-withdrawal on the cold pressor task. The associations were stronger in older participants, indicating an interaction with age.
认知表现对疼痛耐受度的影响已有记录，但样本量较小，且常忽略混杂因素。我们旨在确定神经心理学测试的表现与疼痛耐受度相关，同时控制显著的混杂因素。
这是一项嵌套在特罗姆瑟 6 号调查中的横断面研究。在 4623 名参与者中，研究了神经心理学测试表现和冷水压迫测试。由于与年龄存在显著交互作用，参与者被分为三组（<60 岁、≥60 岁至<70 岁和≥70 岁）。使用手部撤回作为事件，Cox 比例风险模型评估了神经心理学测试与冷压痛耐受力之间的关系。完全调整模型控制了性别、教育、BMI、吸烟状况、运动、收缩压、睡眠问题和精神困扰。
在调整后的模型中，≥70 岁的参与者在即时言语回忆的标准偏差上每增加 18%（HR0.82，95%CI（0.73，0.92）），手部撤回的危险度降低 18%；在精神运动速度的标准偏差上每增加 18%（HR0.77，95%CI（0.65，0.08）），手部撤回的危险度降低 23%。≥60 岁至<70 岁的参与者在即时单词回忆的标准偏差上每降低 11%（HR0.89，95%CI（0.80，0.98）），手部撤回的危险度降低 11%。<60 岁的参与者，在精神运动速度的标准偏差上每降低 14%（HR0.86，95%CI：0.76，0.98），手部撤回的危险度降低 14%。
神经心理学测试表现更好的人在冷水压迫测试中疼痛耐受度更高。这些暴露效应在所有年龄组中均存在。
本文描述了 4623 名参与者中认知功能与冷水压迫耐受力之间的实质性关联。精神运动速度降低和言语回忆能力差，使冷水压迫任务中手部撤回的几率更高。在年龄较大的参与者中，关联更强，表明与年龄存在交互作用。
