The Mind-Body Lab, Department of Psychology, University of Oslo, Gaustadalleen 30, Oslo, Norway.
Department of Pain Management & Research, Oslo University Hospital, Oslo, Norway.
Sci Rep. 2021 Jan 12;11(1):673. doi: 10.1038/s41598-020-80740-0.
Existing studies on cognitive impairments in chronic pain do not investigate peripheral neuropathic pain (PNP) or compare pain conditions in a satisfactory manner. Here we aimed to compare executive dysfunctions in PNP patients with fibromyalgia (FM) and healthy controls (HC). Patients who self-reported cognitive impairments were assessed according to criteria for PNP or FM. Seventy-three patients met criteria and completed testing on executive functioning and IQ measures. We also included twenty matched healthy controls. Regression models controlling for age, sex and IQ, tested associations between group category (PNP, FM or HC) and outcomes. If a substantial association was detected, we followed up with head-to-head comparisons between PNP and FM. Multivariate regression models then tested associations between executive functioning and pain type, controlling for significant confounders. Results from head-to-head comparison between pain conditions showed significant differences on years lived with pain (FM > PNP), the use of anticonvulsants (PNP > FM) and use of analgesics (PNP > FM). When controlled for all significant differences, PNP patients had significantly lower scores on an attention-demanding cued-recall task compared to FM. Poor performance on attention-demanding cued-recall task was associated with PNP, which translate into problems with retaining fast-pace or advanced information.
现有研究表明，慢性疼痛患者存在认知障碍，但这些研究并未针对周围神经病理性疼痛（PNP）进行调查，也未能令人满意地比较不同疼痛状况。本研究旨在比较 PNP 患者、纤维肌痛（FM）患者和健康对照者（HC）的执行功能障碍。根据 PNP 或 FM 的标准，对自我报告认知障碍的患者进行评估。73 名患者符合标准并完成了执行功能和智商测试。我们还纳入了 20 名匹配的健康对照者。回归模型控制年龄、性别和智商，检验了组类别（PNP、FM 或 HC）与结果之间的关联。如果检测到显著关联，我们则进行 PNP 和 FM 之间的直接比较。然后，多变量回归模型控制了显著混杂因素，检验了执行功能与疼痛类型之间的关联。疼痛状况的直接比较结果显示，在疼痛持续时间（FM > PNP）、抗惊厥药的使用（PNP > FM）和镇痛药的使用（PNP > FM）方面存在显著差异。当控制所有显著差异时，PNP 患者在注意力要求高的线索回忆任务上的得分明显低于 FM 患者。注意力要求高的线索回忆任务表现不佳与 PNP 相关，这意味着患者在保留快速或高级信息方面存在问题。
