Rader Lydia, Wager Tor D, Friedman Naomi P
Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States.
Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, United States.
Pain. 2025 Jan 1;166(1):212-221. doi: 10.1097/j.pain.0000000000003347. Epub 2024 Aug 6.
Worse executive function (EF) is associated with chronic pain and could mechanistically contribute to pain chronification. It is unclear whether there is overall impairment in EFs or whether there are impairments in specific cognitive domains. Furthermore, the possible genetic risk underlying these associations has not been tested. Participants were from the Colorado Longitudinal Twin study; 786 same-sex twins completed a battery of EF tasks at ages 23 and/or 28 and 634 of these twins self-reported chronic pain at mean age = 28.1; prevalence = 27.76% using the Brief Pain History Questionnaire. The EF tasks were used to define a Common EF factor and 2 factors specific to updating working memory and shifting mental set. We estimated the phenotypic and genetic associations of stable EF variance across ages 23 and 28, as well as EF variance unique to age 28, with pain. With respect to stable EF variance, pain phenotypically correlated with the Updating-specific factor ( r = -0.21, P = 0.008) but did not significantly correlate with the Common EF factor ( r = -0.06, P = 0.350) nor with the Shifting-specific factor ( r = -0.03, P = 0.709). There were no significant phenotypic correlations between pain and EF variance unique to age 28. A twin model indicated that pain and Updating-specific variance share genetic risk ( r A = -0.46, P = 0.005) but not environmental risk ( r E = 0.05, P = 0.844). Updating working memory shares a phenotypic and genetic relationship with pain in young adults. Impairments in gating or monitoring pain signals may play a mechanistic role in pain development.
较差的执行功能（EF）与慢性疼痛相关，并且可能在机制上促成疼痛慢性化。目前尚不清楚执行功能是否存在整体损害，或者特定认知领域是否存在损害。此外，这些关联背后可能的遗传风险尚未得到检验。参与者来自科罗拉多纵向双胞胎研究；786对同性双胞胎在23岁和/或28岁时完成了一系列执行功能任务，其中634对双胞胎在平均年龄28.1岁时自我报告有慢性疼痛；使用简短疼痛病史问卷得出患病率为27.76%。执行功能任务用于定义一个共同的执行功能因素以及两个分别特定于更新工作记忆和转换思维定势的因素。我们估计了23岁和28岁时稳定的执行功能方差以及28岁时特有的执行功能方差与疼痛之间的表型和遗传关联。关于稳定的执行功能方差，疼痛与特定于更新的因素呈表型相关（r = -0.21，P = 0.008），但与共同的执行功能因素无显著相关性（r = -0.06，P = 0.350），与特定于转换的因素也无显著相关性（r = -0.03，P = 0.709）。疼痛与28岁时特有的执行功能方差之间无显著的表型相关性。一个双胞胎模型表明，疼痛与特定于更新的方差共享遗传风险（rA = -0.46，P = 0.005），但不共享环境风险（rE = 0.05，P = 0.844）。在年轻人中，更新工作记忆与疼痛存在表型和遗传关系。在疼痛信号的门控或监测方面的损害可能在疼痛发展中起机制性作用。
