Relevance of neurocognition in chronic pain syndrome: a systematic and methodical approach

ABSTRACT

Introduction

Subjective and objective deficits in neurocognitive domains are well-documented in patients with chronic pain. However, neurocognitive deficits have not been investigated consistently. The main objective of this study was to conduct a comprehensive assessment of self-rated and objectively assessed cognitive differences between patients with chronic pain (CP) and healthy controls (HC).

Method

The cognitive functioning of 40 CP and 41 HC was assessed using a standardized computer-based test battery, enabling a comparison of subjective and objective neurocognitive factors. To achieve this, the Vienna Test System (VTS) was utilized, incorporating standardized tests from the Cognitive Basic Assessment Battery (COGBAT) with the advantage of objectivity, reliability, validity, efficiency, utility, and standardization. This approach enables the evaluation of cognitive functioning across all pertinent domains.

Results

CP reported cognitive deficits in overall performance as well as specific functions, such as attention, memory, and executive functions. Across all neurocognitive domains, CP showed a poorer performance. Affected subdomains of attention were intensity and selectivity of attention. Lower performance was found also in concentration performance, obtaining and overview, visual orientation performance and reactive stress tolerance. Regarding memory, CP performed worse in figural episodic memory and recognition tasks. In addition, CP exhibited poorer performance in mental flexibility, working memory, planning ability, and inhibition as components of executive functioning, when compared to HC.

Conclusions

CP expressed subjective cognitive deficits and demonstrated impaired neurocognitive performance.

KEYWORDS:

• Chronical pain
• neurocognition
• subjective cognitive deficits
• interdisciplinary multimodal pain therapy
• neuropsychological therapy

Acknowledgments

We thank all probands for their participation in this study. We thank the Medical Faculty of University of Heidelberg for enabling the study in the context of the PhD thesis of J.S. We thank the Schuhfried GmbH for providing us with neuropsychological diagnostic and training tools. At last, we thank SRH Clinic Karlsbad-Langensteinbach for supporting and funding this study.

Disclosure statement

M.W. has contracts for the development of neuropsychological diagnostic and training tools with the Schuhfried GmbH. The other authors report there are no competing interests to declare.

Data availability statement

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13803395.2024.2314732.

Notes

1. T1: Point of time 1.

2. T2: Point of time 2.

3. For the variable reactive stress tolerance (false reactions), a significant influence of depression was found (diagnosis of depression in the doctor’s letter). In this case, however, the group difference was not significant.

Additional information

Funding

This work was supported and funded by SRH Clinic Karlsbad-Langensteinbach.