Schmidt Janna, Fritz Michael, Weisbrod Matthias
Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.
Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.
J Clin Exp Neuropsychol. 2023 Nov;45(9):874-889. doi: 10.1080/13803395.2024.2314732. Epub 2024 Feb 26.
Subjective and objective deficits in neurocognitive domains are well-documented in patients with chronic pain. However, neurocognitive deficits have not been investigated consistently. The main objective of this study was to conduct a comprehensive assessment of self-rated and objectively assessed cognitive differences between patients with chronic pain (CP) and healthy controls (HC).
The cognitive functioning of 40 CP and 41 HC was assessed using a standardized computer-based test battery, enabling a comparison of subjective and objective neurocognitive factors. To achieve this, the Vienna Test System (VTS) was utilized, incorporating standardized tests from the Cognitive Basic Assessment Battery (COGBAT) with the advantage of objectivity, reliability, validity, efficiency, utility, and standardization. This approach enables the evaluation of cognitive functioning across all pertinent domains.
CP reported cognitive deficits in overall performance as well as specific functions, such as attention, memory, and executive functions. Across all neurocognitive domains, CP showed a poorer performance. Affected subdomains of attention were intensity and selectivity of attention. Lower performance was found also in concentration performance, obtaining and overview, visual orientation performance and reactive stress tolerance. Regarding memory, CP performed worse in figural episodic memory and recognition tasks. In addition, CP exhibited poorer performance in mental flexibility, working memory, planning ability, and inhibition as components of executive functioning, when compared to HC.
CP expressed subjective cognitive deficits and demonstrated impaired neurocognitive performance.
慢性疼痛患者在神经认知领域的主观和客观缺陷已有充分记录。然而，对神经认知缺陷的研究并不一致。本研究的主要目的是全面评估慢性疼痛（CP）患者与健康对照（HC）之间自我报告的认知差异和客观评估的认知差异。
使用标准化的计算机测试组合对40名CP患者和41名HC的认知功能进行评估，以便比较主观和客观神经认知因素。为此，采用了维也纳测试系统（VTS），该系统纳入了认知基本评估组合（COGBAT）中的标准化测试，具有客观性、可靠性、有效性、效率、实用性和标准化的优点。这种方法能够评估所有相关领域的认知功能。
CP患者报告在整体表现以及特定功能（如注意力、记忆和执行功能）方面存在认知缺陷。在所有神经认知领域，CP患者表现较差。注意力受影响的子领域是注意力的强度和选择性。在注意力集中表现、获取和概述、视觉定向表现以及反应性应激耐受性方面也发现表现较低。在记忆方面，CP患者在图形情景记忆和识别任务中表现更差。此外，与HC相比，CP患者在作为执行功能组成部分的心理灵活性、工作记忆、计划能力和抑制方面表现更差。
CP患者表现出主观认知缺陷，并显示出神经认知表现受损。
