van den Berg Corinne, van den Berg Esther, Huygen Frank J P M, Tiemensma Jitske
Department of Anesthesiology, Center for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Eur J Pain. 2025 Jul;29(6):e70046. doi: 10.1002/ejp.70046.
Given the impact of chronic pain on cognition, CRPS may affect specific cognitive functions. However, cognitive functioning is rarely assessed in CRPS, and previous studies have examined only limited domains. As a result, it remains unclear which cognitive functions are affected and whether impairments are CRPS-specific. This study comprehensively evaluates cognition in CRPS and compares it to carpal tunnel syndrome (CTS) to determine whether cognitive dysfunction is specific to CRPS.
All patients underwent a standardised cognitive assessment consisting of ten tests, evaluating the domains of memory, concentration, executive functioning, social cognition and performance validity. Standardised z-scores and proportion of low-performing patients (< -1.5 SD from age-, sex- and education adjusted normative data) were examined. Both patient groups were compared with each other and the expected population proportion.
Sixty-four patients (n = 39 CRPS and n = 25 CTS) with a mean age of 52.5 (range 20-81) were included. Compared with patients with CTS, patients with CRPS had significantly higher pain scores 24 h before and during the visit (p < 0.001). All cognitive test results were similar between the two groups. Z-scores of both groups were comparable or better than the population norm. Furthermore, proportions of patients with Z-scores below -1.5 SD were similar or better than expected.
Our results consistently showed no cognitive impairment in either patient group. Both groups met or exceeded population norms on all tests. However, despite our clear results, attention should be paid to factors affecting cognition, like depression, anxiety and stress.
This study explores the underexamined cognitive dysfunction in Complex Regional Pain Syndrome (CRPS). Cognitive issues, often reported by CRPS patients, can add to the burden on daily life and quality of life (QoL) but are rarely assessed. By comparing CRPS with CTS, this research examines whether cognitive impairments are specific to CRPS. Identifying these issues may lead to targeted therapies addressing both pain and cognitive challenges, ultimately improving patient outcomes and QoL.
鉴于慢性疼痛对认知的影响，复杂性区域疼痛综合征（CRPS）可能会影响特定的认知功能。然而，CRPS患者的认知功能很少得到评估，并且先前的研究仅考察了有限的领域。因此，目前尚不清楚哪些认知功能受到影响，以及这些损害是否具有CRPS特异性。本研究全面评估了CRPS患者的认知功能，并将其与腕管综合征（CTS）患者进行比较，以确定认知功能障碍是否为CRPS所特有。
所有患者均接受了一项标准化认知评估，该评估由十项测试组成，用于评估记忆、注意力、执行功能、社会认知和表现效度等领域。研究人员检查了标准化z分数以及表现不佳患者的比例（低于年龄、性别和教育程度调整后的规范数据的-1.5个标准差）。将两组患者相互比较，并与预期的总体比例进行比较。
纳入了64例患者（n = 39例CRPS患者和n = 25例CTS患者），平均年龄为52.5岁（范围20 - 81岁）。与CTS患者相比，CRPS患者在就诊前24小时及就诊期间的疼痛评分显著更高（p < 0.001）。两组患者的所有认知测试结果相似。两组的z分数与总体规范相当或更好。此外，z分数低于-1.5个标准差的患者比例与预期相似或更好。
我们的结果一致表明，两组患者均无认知障碍。两组在所有测试中均达到或超过了总体规范。然而，尽管我们的结果明确，但仍应关注影响认知的因素，如抑郁、焦虑和压力。
本研究探讨了复杂性区域疼痛综合征（CRPS）中尚未得到充分研究的认知功能障碍。CRPS患者经常报告认知问题，这些问题会加重日常生活负担并影响生活质量（QoL），但很少得到评估。通过将CRPS与CTS进行比较，本研究考察了认知障碍是否为CRPS所特有。识别这些问题可能会带来针对性的治疗方法，既能解决疼痛问题，又能应对认知挑战，最终改善患者的治疗效果和生活质量。
