Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, Arizona.
Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, Arizona.
J Pain. 2021 Nov;22(11):1467-1476. doi: 10.1016/j.jpain.2021.04.016. Epub 2021 May 20.
Cognitive impairment associated with chronic pain remains relatively poorly understood. Use of analgesic drugs and often present co-morbidities in patients can preclude conclusions of causative relationships between chronic pain and cognitive deficits. Here, the impact of pain resulting from spinal nerve ligation (SNL) injury in rats on short and long-term memory was assessed in the novel object recognition task. To understand if chronic pain seizes the limited cognitive resources that are available at any given time, task difficulty was varied by using either very different (ie, easy task) or similar (ie, difficult task) pairs of objects. Nerve-injured, male rats exhibited no short or long-term memory deficits under easy task conditions. However, unlike sham-operated controls, injured rats showed deficits in both short and long-term memory by failing to differentiate similar objects in the difficult task version. In SNL rats, duloxetine produced anti-allodynic effects and ameliorated long-term memory deficits in the difficult task suggesting benefits of pain relief possibly complemented by noradrenergic mediated cognitive enhancement. Together these data suggest chronic pain reversibly takes up a significant amount of limited cognitive resources, leaving sufficient available for easy, but not difficult, tasks. PERSPECTIVE: Memory deficits in a rat model of chronic pain were only seen when the cognitive load was high, ie, in a difficult task. Acute treatment with duloxetine was sufficient to relieve memory deficits, suggesting chronic pain induces memory deficits by seizing limited cognitive resources to the detriment of task-related stimuli.
慢性疼痛相关认知障碍的机制仍知之甚少。由于患者常使用镇痛药物且伴有合并症,这可能会影响对慢性疼痛与认知障碍之间因果关系的判断。本研究通过大鼠脊神经结扎(SNL)损伤模型评估了疼痛对短期和长期记忆的影响,并在新物体识别任务中进行了研究。为了了解慢性疼痛是否会占用任何特定时间内有限的认知资源,我们通过使用非常不同(即简单任务)或相似(即困难任务)的物体对来改变任务难度。结果发现,在简单任务条件下,神经损伤的雄性大鼠没有出现短期或长期记忆缺陷。然而,与假手术对照组不同,损伤大鼠在困难任务版本中未能区分相似物体,表现出短期和长期记忆缺陷。在 SNL 大鼠中,度洛西汀具有抗痛觉过敏作用,并改善了困难任务中的长期记忆缺陷,这表明疼痛缓解可能通过去甲肾上腺素能介导的认知增强起到补充作用。这些数据表明,慢性疼痛会暂时占用大量有限的认知资源,导致大鼠只能完成简单任务,而无法完成困难任务。观点:只有在认知负荷较高(即困难任务)时,慢性疼痛大鼠模型才会出现记忆缺陷。度洛西汀的急性治疗足以缓解记忆缺陷,这表明慢性疼痛通过占用有限的认知资源来损害与任务相关的刺激,从而导致记忆缺陷。