Zhao Lei, Zhang Libo, Tang Yilan, Tu Yiheng
Key Laboratory of Cognitive Science and Mental Health, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Neuroscience and Behaviour Laboratory, Italian Institute of Technology, Rome, Italy.
Trends Cogn Sci. 2025 Jun;29(6):570-585. doi: 10.1016/j.tics.2024.12.004. Epub 2025 Jan 2.
Chronic pain (CP) not only causes physical discomfort but also significantly affects cognition. This review first summarizes emerging findings that reveal complex associations between CP and cognitive impairments, and then presents neuroimaging evidence showing aging-related brain alterations in CP and proposes a framework where accelerated brain aging links CP to cognitive impairments. This framework explains how CP-related multi-level factors, which either contribute to the onset of CP or arise as a result of CP, influence brain aging in linear and nonlinear ways, leading to cognitive impairments and increased dementia risk. Leveraging interpretable machine learning and molecular brain atlases, this framework enables the development of cognitive risk assessment indicators and elucidates the biological mechanisms underlying cognitive impairments in CP.
慢性疼痛（CP）不仅会引起身体不适，还会对认知产生重大影响。本综述首先总结了新出现的研究结果，这些结果揭示了CP与认知障碍之间的复杂关联，然后展示了神经影像学证据，表明CP患者存在与衰老相关的大脑改变，并提出了一个框架，其中加速的大脑衰老将CP与认知障碍联系起来。该框架解释了与CP相关的多层面因素，这些因素要么促成CP的发生，要么是CP导致的结果，如何以线性和非线性方式影响大脑衰老，导致认知障碍和痴呆风险增加。利用可解释的机器学习和分子脑图谱，该框架能够开发认知风险评估指标，并阐明CP中认知障碍的生物学机制。
