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      The Cognitive Functions in Adults with Chronic Pain: A Comparative Study

      research-article
      * , ,
      Pain Research & Management
      Hindawi Publishing Corporation

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          Abstract

          Background. Several studies have reported an association between chronic pain and reduction of cognitive abilities of adults living in Western cultures. No literature could be found on the relationship between chronic pain and cognition among Middle Eastern adults. Objective. To compare four of the most commonly reported cognitive domains [memory, attention, processing speed, and executive functioning] among Middle Eastern adults with and without chronic pain. Methods. This matched group comparative study included 69 community residing and functionally independent Middle Eastern adults. Forty participants had chronic pain and 29 were pain-free. We administered five standardized cognitive assessments that are independent of culture and language to measure variable tasks of memory, attention, processing speed, and executive functioning. The study was conducted in a rehabilitation research setting with a controlled environment. Results. Evidence of decreased cognitive processing was found in patients with chronic pain. The chronic pain participants performed significantly worse than the pain-free participants on the cognitive measures of long-term memory, selective attention, processing speed, and executive functioning. Conclusion. The effect of Middle Eastern culture on the cognitive abilities of patients with chronic pain was negligible. Despite the wide variations between Eastern and Western cultures, the performance of our Middle Eastern participants in this study was consistent with performance of Western adults reported in previous studies.

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          Most cited references47

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          Chronic back pain is associated with decreased prefrontal and thalamic gray matter density.

          The role of the brain in chronic pain conditions remains speculative. We compared brain morphology of 26 chronic back pain (CBP) patients to matched control subjects, using magnetic resonance imaging brain scan data and automated analysis techniques. CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures. Neocortical gray matter volume was compared after skull normalization. Patients with CBP showed 5-11% less neocortical gray matter volume than control subjects. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal aging. The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain. Regional gray matter density in 17 CBP patients was compared with matched controls using voxel-based morphometry and nonparametric statistics. Gray matter density was reduced in bilateral dorsolateral prefrontal cortex and right thalamus and was strongly related to pain characteristics in a pattern distinct for neuropathic and non-neuropathic CBP. Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.
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            Executive function.

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              The d2 Test of attention: construct validity and extensions in scoring techniques.

              The internal consistency and convergent and discriminant validity of the d2 Test, a cancellation test of attention and concentration, was examined in a sample of 364 U.S. adults. Test-taking strategy, new process scores for assessing performance constancy, and relations to gender and education were explored. Results suggested that the d2 Test is an internally consistent and valid measure of visual scanning accuracy and speed. Overall performance scores were related to a proxy measure of test-taking strategy in the expected direction, and new acceleration and deterioration measures exhibited convergent validity. Suggested directions for future research include discrimination of attentional processes that support immediate and sustained visual scanning accuracy and speed, further examination of the impact of test-taking strategies on overall performance measures, and additional construct validity examinations for the new process measures.
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                Author and article information

                Journal
                Pain Res Manag
                Pain Res Manag
                PRM
                Pain Research & Management
                Hindawi Publishing Corporation
                1203-6765
                1918-1523
                2016
                29 December 2016
                : 2016
                : 5719380
                Affiliations
                Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Jabriya, Kuwait
                Author notes
                *Mohammed Shaban Nadar: ot_nadar@ 123456hsc.edu.kw

                Academic Editor: Gerrit Hirschfeld

                Author information
                http://orcid.org/0000-0003-4281-5630
                Article
                10.1155/2016/5719380
                5227177
                6c2ca2a9-e63f-4701-97d0-7996ee51136f
                Copyright © 2016 Mohammed Shaban Nadar et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 July 2015
                : 22 November 2016
                Categories
                Research Article

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