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慢性疼痛对认知功能的影响。

The Impact of Chronic Pain on Cognitive Function.

作者信息

Patel Milan, Hasoon Jamal, Diez Tafur Rodrigo, Lo Bianco Giuliano, Abd-Elsayed Alaa

机构信息

Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53705, USA.

Department of Anesthesiology, Critical Care, and Pain Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA.

出版信息

Brain Sci. 2025 May 24;15(6):559. doi: 10.3390/brainsci15060559.

Abstract

: Chronic pain affects a significant proportion of the population in the United States and poses a significant public health concern. Beyond physical discomfort, chronic pain has been increasingly linked to cognitive dysfunction, including impairments in memory, attention, executive function, and decision-making. The relationship is particularly pronounced in older adults and may contribute to the onset or progression of neurodegenerative diseases. : This comprehensive review explores the relationship between chronic pain and cognitive function, emphasizing the underlying neurobiological mechanisms, structural brain changes, and associated comorbidities. : A review was conducted using peer-reviewed studies that began with the earliest pain and cognition mechanisms, followed by further investigation of cognitive effects of chronic pain, neuroimaging findings, and comorbid neuropsychiatric and neurodegenerative conditions. Sources included large-scale cohort studies, functional MRI analyses, and neurobiological investigations focusing on prefrontal cortex activity, default mode network alterations, and gray matter atrophy. : Chronic pain is associated with cognitive deficits through multiple converging pathways. It contributes to measurable impairments in cognitive function and is linked to structural and functional brain alterations. Regions of interest include the dorsolateral prefrontal cortex, medial prefrontal cortex, and default mode network, which can be connected to the neural resource hypothesis because of their cognitive domain impairments. A better understanding of these mechanisms highlights the importance of early recognition and multidisciplinary management strategies, including neuromodulation and cognitive rehabilitation. Future research should prioritize longitudinal studies and integrated interventions targeting both pain and cognitive health.

摘要

慢性疼痛影响着美国相当一部分人口,是一个重大的公共卫生问题。除了身体不适外,慢性疼痛与认知功能障碍的关联日益增加,包括记忆、注意力、执行功能和决策方面的损害。这种关系在老年人中尤为明显,可能会导致神经退行性疾病的发生或进展。

本综述探讨了慢性疼痛与认知功能之间的关系,重点关注潜在的神经生物学机制、大脑结构变化以及相关的合并症。

通过对同行评审研究进行综述,从最早的疼痛与认知机制开始,接着进一步研究慢性疼痛的认知影响、神经影像学发现以及合并的神经精神和神经退行性疾病状况。资料来源包括大规模队列研究、功能磁共振成像分析以及聚焦前额叶皮质活动、默认模式网络改变和灰质萎缩的神经生物学研究。

慢性疼痛通过多种汇聚途径与认知缺陷相关联。它导致认知功能出现可测量的损害,并与大脑结构和功能改变有关。感兴趣的区域包括背外侧前额叶皮质、内侧前额叶皮质和默认模式网络,由于它们在认知领域的损害,可与神经资源假说联系起来。更好地理解这些机制凸显了早期识别和多学科管理策略的重要性,包括神经调节和认知康复。未来的研究应优先进行纵向研究以及针对疼痛和认知健康的综合干预。

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