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Nabih MI, Khalil NM, Shaker O, Ghanema M, Hassan SA. Cognitive dysfunction, depression and serum level of brain-derived neurotrophic factor (BDNF) in Egyptian patients with rheumatoid arthritis. REUMATOLOGIA CLINICA 2024; 20:175-180. [PMID: 38644028 DOI: 10.1016/j.reumae.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/17/2023] [Accepted: 12/14/2023] [Indexed: 04/23/2024]
Abstract
AIM OF THE WORK To evaluate serum brain-derived neurotrophic factor (BDNF) in Egyptian patients with rheumatoid arthritis (RA) and its relation with cognitive dysfunction. PATIENTS AND METHODS The study was carried out on 60 RA patients; 30 were active (group A) and 30 were non active (group B); and 30 controls (group C). RA disease activity was assessed via DAS28 tool, cognitive function via The Montreal Cognitive Assessment and depression via the PHQ depression scale. Serum BDNF levels were measured. RESULTS The mean age in group A was 37.8 (±9.37) years with 83.3% females, in group B was 39.97 (±8.04) years with 86.7% females and in group C was 33.17 (±3.6) years with 93.3% females. Abnormal cognitive functions test was detected in 66.7% of group A, 66.7% of group B, and in 23.3% of group C. There was a statistically significant difference in BDNF serum level between both groups of patients (1.58±0.9ng/ml for group A, 1.81±1.17ng/ml for group B) compared with the control group (3.01±1.25ng/ml, p<0.001). There was no statistically significant difference between BDNF and both disease duration and cognitive function, also no statistically significant difference regarding cognitive function, depression, and BNDF levels in patients with and without fibromyalgia. At a cut-off value of <2ng/ml, BDNF detected RA patients with cognitive dysfunction with a sensitivity of 80%, specificity of 96.67%. CONCLUSION BDNF can be a potential biomarker of cognitive dysfunction in RA patients.
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Affiliation(s)
- Mona I Nabih
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Egypt
| | - Olfat Shaker
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Egypt
| | - Mahmoud Ghanema
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Egypt
| | - Sarah A Hassan
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Egypt.
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Galvez-Sánchez CM, Duschek S, Reyes del Paso GA. A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications. Psychol Res Behav Manag 2024; 17:1399-1415. [PMID: 38566824 PMCID: PMC10985931 DOI: 10.2147/prbm.s446798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated. Patients and Methods A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons. Results Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients. Conclusion The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.
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Affiliation(s)
- Carmen M Galvez-Sánchez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Stefan Duschek
- Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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Duan L, Li S, Li H, Shi Y, Xie X, Feng Y. Causality between rheumatoid arthritis and the risk of cognitive impairment: a Mendelian randomization study. Arthritis Res Ther 2024; 26:5. [PMID: 38167504 PMCID: PMC10759661 DOI: 10.1186/s13075-023-03245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is mounting proof that rheumatoid arthritis (RA) and cognitive decline are related. These studies, however, have not all been uniform, and others have not discovered such a correlation. It is essential to investigate the link between RA and cognitive decline. METHOD We conducted a Mendelian randomization analysis utilizing three different publicly accessible RA GWAS summary datasets and a variety of meticulously verified instrumental variables. We mostly used inverse variance weighting (IVW), as well as MR-Egger, weighted median, MR-PRESSO, and several sensitivity analyses, to figure out the link between RA and cognitive impairment (CI). RESULTS Our MR study identified the causality between RA and declining cognitive performance (β = - 0.010, 95% CI of - 0.017 to - 0.003, P = 4.33E-03) and cognitive function (β = - 0.029, 95% CI of - 0.053 to - 0.005, P = 1.93E-02). The consistent direction of the connection is revealed by sensitivity analysis utilizing the weighted median and the MR-Egger method. Furthermore, we reproduced our findings across two additional RA datasets and found identical outcomes, strengthening the validity of our findings. CONCLUSION This study offers proof of causality between RA and an increased risk of CI. Our findings highlight the importance of examining RA patients for cognitive ability, which may open up fresh ideas for the prevention of CI.
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Affiliation(s)
- Lincheng Duan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shiyin Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Haoming Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Shi
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaolong Xie
- Meishan Hospital of Traditional Chinese Medicine, Affiliated Meishan Hospital of Chengdu University of Traditional Chinese Medicine, Meishan, China.
| | - Yue Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Schmidt J, Fritz M, Weisbrod M. Relevance of neurocognition in chronic pain syndrome: a systematic and methodical approach. J Clin Exp Neuropsychol 2023; 45:874-889. [PMID: 38406973 DOI: 10.1080/13803395.2024.2314732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/27/2023] [Indexed: 02/27/2024]
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.
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Affiliation(s)
- Janna Schmidt
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Fritz
- Department of Neurology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Chen YT, Lescoat A, Khanna D, Murphy SL. Perceived Cognitive Function in People With Systemic Sclerosis: Associations With Symptoms and Daily Life Functioning. Arthritis Care Res (Hoboken) 2023; 75:1706-1714. [PMID: 35997486 PMCID: PMC9947182 DOI: 10.1002/acr.25000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/30/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Perceived cognitive dysfunction is prevalent in patients with systemic sclerosis (SSc) but not well understood. This study aimed to examine potential factors associated with perceived cognitive function and to investigate the contributions of perceived cognitive function and symptoms to functional measures. METHODS A cross-sectional survey was conducted among patients with SSc (n = 106). Participants were mainly female (84%) and White (82%). Perceived cognitive function, symptoms, and functional measures were assessed with Patient-Reported Outcomes Measurement Information System (PROMIS) measures. A multivariable regression was conducted to identify factors associated with perceived cognition. Hierarchical linear regressions examined the unique contributions of perceived cognitive function and symptoms to social participation and physical function. RESULTS Fifty-nine (56%) patients with SSc perceived mild-to-severe cognitive dysfunction. Being on work disability and having more fatigue were both significantly associated with perceived cognitive dysfunction. When examining the contributions of cognition and other symptoms to functional measures, self-reported cognition became nonsignificant after fatigue and pain were entered into the regression model. CONCLUSION Being on work disability and having more fatigue were most highly associated with perceived cognitive dysfunction in patients with SSc. Unlike fatigue and pain, perceived cognitive function was not independently associated with functional measures. Nonetheless, future research should disentangle cognitive function and other symptoms, as well as their effects on daily activities, in SSc.
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Affiliation(s)
- Yen T. Chen
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Alain Lescoat
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Dinesh Khanna
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan L. Murphy
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
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Chen J, Wang X, Xu Z. The Relationship Between Chronic Pain and Cognitive Impairment in the Elderly: A Review of Current Evidence. J Pain Res 2023; 16:2309-2319. [PMID: 37441267 PMCID: PMC10335316 DOI: 10.2147/jpr.s416253] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Chronic pain and cognitive impairment are prevalent geriatric syndromes in the population of older adults, and they are the main cause of disability in people over sixty-five years of age. As the global population continues to age, chronic pain and cognitive impairment will affect an increasing number of older adults. While numerous studies in recent years have shown that chronic pain is associated with cognitive decline, the exact mechanisms linking the two remain unclear. In this review, we aim to present the available evidence on the connection between chronic pain and cognitive impairment and to discuss the potential mechanisms by which chronic pain affects cognitive function. In addition, we review potential therapeutic interventions targeting psychological factors, microglia activation, and altered gut flora that may improve and prevent cognitive decline in people with chronic pain.
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Affiliation(s)
- Jintao Chen
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
| | - Xinyi Wang
- Department of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zherong Xu
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
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Kang W, Whelan E, Malvaso A. Understanding Cognitive Deficits in People with Arthritis. Healthcare (Basel) 2023; 11:healthcare11091337. [PMID: 37174879 PMCID: PMC10178460 DOI: 10.3390/healthcare11091337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Cognitive deficits are commonly seen in people with arthritis. However, previous studies focused primarily on small-sized clinical samples. There is a need for cohort-based studies, which are characterized by high generalizability. In addition, these studies mainly focused on attention, memory, and executive function. However, cognition is not a single concept, but includes other cognitive domains, such as verbal fluency and arithmetic abilities. Thus, we aim to explore how arthritis can affect cognitive abilities, including episodic memory, semantic verbal fluency, fluid reasoning, and numerical ability by using a large cohort from the United Kingdom. The main findings were that people with arthritis have significantly lower immediate word recall (t(2257) = -6.40, p < 0.001, Cohen's d = -0.12, 95% C.I. = [-0.16, -0.08]), delayed word recall (t(2257) = -5.60, p < 0.001, Cohen's d = -0.11, 95% C.I. = [-0.14, -0.07]), semantic verbal fluency (t(2257) = -3.03, p < 0.01, Cohen's d = -0.06, 95% C.I. = [-0.10, -0.02]), fluid reasoning (t(2257) = -3.96, p < 0.001, Cohen's d = -0.07, 95% C.I. = [-0.11, -0.04]), and numerical ability (t(2257) = -3.85, p < 0.001, Cohen's d = -0.07, 95% C.I. = [-0.10, -0.03]) compared to what they would expect given their demographics. Interventions are needed to improve cognitive abilities in people with arthritis.
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Affiliation(s)
- Weixi Kang
- Imperial College London, London SW7 2BX, UK
| | - Edward Whelan
- Independent Researcher, 99MX QH Maynooth, County Kildare, Ireland
| | - Antonio Malvaso
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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Kleinert S, Schuch F, Rapp P, Ronneberger M, Wendler J, Sternad P, Popp F, Bartz-Bazzanella P, von der Decken C, Karberg K, Gauler G, Wurth P, Späthling-Mestekemper S, Kuhn C, Englbrecht M, Vorbrüggen W, Adler G, Welcker M. Impairment in cognitive function in patients with axial spondyloarthritis and psoriatic arthritis. Rheumatol Int 2023; 43:89-97. [PMID: 36441274 DOI: 10.1007/s00296-022-05248-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
Spondyloarthritis may contribute to deficits in cognition. The objective of this study was to compare cognitive abilities in patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) with matched reference groups. This investigator-initiated, cross-sectional, exploratory study of adults with axSpA or PsA was conducted at two German rheumatology centres (November 2018-September 2019). All data on patient and disease characteristics and cognitive abilities were collected at a single visit. Cognitive function was assessed by the previously validated Memory and Attention Test subscores of selective attention, episodic working memory, and episodic short-term memory and compared with subscores from healthy age-, sex-, and education-matched reference subjects. The mean patient age was 51.1 and 55.8 years in the axSpA (n = 101) and PsA (n = 117) groups, respectively, and mean symptom duration was 13.7 and 10.3 years. Compared with matched reference subjects, axSpA and PsA patients showed significant impairments in selective attention (mean difference of -6.5 and -4.5, respectively, on a 45-point scale; P < 0.001 for both) and no significant differences in episodic working memory. The PsA cohort, but not the axSpA cohort, had significantly better episodic short-term memory subscores compared with matched reference subjects (mean change of 2.0 on a 15-point scale; P < 0.001). Explorative subgroup analyses were unable to identify factors influencing cognitive changes, including disease activity, pain, and function, but may have been underpowered. We conclude that impairments in selective attention may impact the ability of axSpA and PsA patients to process information. These findings warrant additional studies, including longitudinal analyses, in patients with spondyloarthritis.
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Affiliation(s)
- Stefan Kleinert
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany.
- Universitätsklinik Würzburg, Med. Klinik 3, Rheumatologie/Klinische Immunologie, Würzburg, Germany.
| | - Florian Schuch
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Praxedis Rapp
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Monika Ronneberger
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Joerg Wendler
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Patrizia Sternad
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
| | - Florian Popp
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
| | | | | | - Kirsten Karberg
- Praxis Für Rheumatologie und Innere Medizin, Berlin, Germany
| | - Georg Gauler
- Rheumatologische Schwerpunktpraxis, Osnabrück, Germany
| | - Patrick Wurth
- Rheumatologische Schwerpunktpraxis, Osnabrück, Germany
| | | | | | | | | | - Georg Adler
- Institut für Studien zur Psychischen Gesundheit (ISPG), Mannheim, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
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McDowell B, Marr C, Holmes C, Edwards CJ, Cardwell C, McHenry M, Meenagh G, McGuinness B. Prevalence of cognitive impairment in patients with rheumatoid arthritis: a cross sectional study. BMC Psychiatry 2022; 22:777. [PMID: 36494656 PMCID: PMC9733399 DOI: 10.1186/s12888-022-04417-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the role of chronic inflammation in rheumatoid arthritis (RA) on cognition. METHODS AND ANALYSIS Six hundred sixty-one men and women aged ≥55 years who fulfilled the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for RA were recruited from three healthcare trusts in the United Kingdom (UK) between May 2018 and March 2020. Study participants took part in interviews which captured sociodemographic information, followed by an assessment of cognition. RA specific clinical characteristics were obtained from hospital medical records. Participants were cognitively assessed using the Montreal Cognitive Assessment (MoCA) and were classified as cognitively impaired if they scored ≤27/30 points. Linear regression analyses were conducted to identify which demographic and clinical variables were potential predictors of cognitive impairment. RESULTS The average age of participants was 67.6 years and 67% (444/661) were women. 72% (458/634; 95% CI 0.69 to 0.76) of participants were classified as cognitively impaired (MoCA≤27). Greater cognitive impairment was associated with older age (p = .006), being male (p = .041) and higher disease activity score (DAS28) (with moderate (DAS28 > 3.1) (p = 0.008) and high (DAS28 > 5.1) (p = 0.008)) compared to those in remission (DAS28 ≤ 2.6). There was no association between MoCA score and education, disease duration, RF status, anti-cyclic citrullinated peptide (anti-CCP) status, RA medication type or use of glucocorticoids or non-steroidal anti-inflammatory drugs (p > 0.05). CONCLUSION This study suggests that cognitive impairment is highly prevalent in older adults with RA. This impairment appears to be associated with higher RA disease activity and supports the concept that chronic systemic inflammation might accelerate cognitive decline. This underlines the importance of controlling the inflammatory response.
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Affiliation(s)
- Bethany McDowell
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Calum Marr
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Clive Holmes
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, England ,grid.467048.90000 0004 0465 4159Southern Health NHS Foundation Trust, Southampton, England
| | - Christopher J. Edwards
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, England ,NIHR Southampton Clinical Research Facility, Southampton, England ,grid.430506.40000 0004 0465 4079University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Christopher Cardwell
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Michelle McHenry
- grid.412915.a0000 0000 9565 2378Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Gary Meenagh
- grid.413824.80000 0000 9566 1119Northern Health and Social Care Trust, Antrim, Northern Ireland
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Schmidt J, Weisbrod M, Fritz M, Aschenbrenner S. Kognition und Kraftfahreignung bei chronischem Schmerzsyndrom. DER NERVENARZT 2022; 94:335-343. [PMID: 36169672 PMCID: PMC10104908 DOI: 10.1007/s00115-022-01387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
ZusammenfassungKognitive Auffälligkeiten bei Patienten mit chronischen Schmerzen finden in wissenschaftlichen Untersuchungen zunehmend Beachtung. Die Folgen dieser kognitiven Störungen in Bezug auf die Schmerzbewältigung, die Alltagsgestaltung und die Kraftfahreignung werden in der klinischen Praxis jedoch kaum berücksichtigt, obwohl die Hälfte aller Patienten davon betroffen ist. Die vorliegende Arbeit fasst die aktuelle Studienlage zusammen und diskutiert Möglichkeiten der Integration in die klinische und therapeutische Versorgung.
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Affiliation(s)
- J Schmidt
- Abteilung für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad, Guttmannstr. 1, 76307, Karlsbad-Langensteinbach, Deutschland.
- Medizinische Fakultät Heidelberg der Universität Heidelberg, Heidelberg, Deutschland.
| | - M Weisbrod
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M Fritz
- Abteilung für Neurologie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
| | - S Aschenbrenner
- Abteilung für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad, Guttmannstr. 1, 76307, Karlsbad-Langensteinbach, Deutschland
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
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Comparison of Mindfulness-Based Stress Reduction Therapy and Cognitive-Behavioral Therapy of Chronic Fatigue, Sleep Quality, Executive Function and Disease Activity in Patients with Rheumatoid Arthritis. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09558-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Chen YT, Lescoat A, Devine A, Khanna D, Murphy SL. Cognitive difficulties in people with systemic sclerosis: a qualitative study. Rheumatology (Oxford) 2022; 61:3754-3765. [PMID: 35015836 PMCID: PMC9259752 DOI: 10.1093/rheumatology/keac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study used a qualitative approach to explore how people with SSc experience cognitive changes and how cognitive difficulties impact their functioning. METHODS Four 90-min focus groups of adults with SSc and self-reported changes in cognition were recruited from a SSc research registry and targeted social media. A focus group guide elicited information from participants via open-ended questions. Content analysis was conducted using grounded theory methodology. RESULTS There were 20 participants (mean age = 55.5 (11.4) years) comprising 16 (80%) females, 14 (70%) Caucasians, and 11 (55%) people with diffuse cutaneous SSc. Study themes included cognitive difficulties as part of daily life experience, impact of cognitive difficulties on daily life functioning, coping strategies and information seeking. Participants used different terms to describe their experience of cognitive difficulties, and most encountered deficits in short-term memory, language difficulties, decreased executive function, difficulties with concentration and focus, and slow processing speed. Participants expressed frustration with their cognitive difficulties and used coping strategies to lessen their impact. Participants were uncertain about the causes and wanted to understand factors contributing to cognitive difficulties as well as how to manage them. CONCLUSION Participants with SSc reported cognitive difficulties that had a substantial negative impact on their lives. Improved understanding of cognitive changes could subsequently facilitate development of relevant therapeutic interventions or educational programmes for symptom self-management to reduce impact of cognitive difficulties in people with SSc.
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Affiliation(s)
- Yen T Chen
- Department of Physical Medicine & Rehabilitation
- Division of Rheumatology, Scleroderma Program, Univerisity of Michigan, Ann Arbor, MI, USA
| | - Alain Lescoat
- Division of Rheumatology, Scleroderma Program, Univerisity of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA
| | - Anita Devine
- Division of Rheumatology, Scleroderma Program, Univerisity of Michigan, Ann Arbor, MI, USA
| | - Dinesh Khanna
- Division of Rheumatology, Scleroderma Program, Univerisity of Michigan, Ann Arbor, MI, USA
- Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA
| | - Susan L Murphy
- Department of Physical Medicine & Rehabilitation
- Division of Rheumatology, Scleroderma Program, Univerisity of Michigan, Ann Arbor, MI, USA
- Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA
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13
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Mena-Vázquez N, Ortiz-Márquez F, Cabezudo-García P, Padilla-Leiva C, Diaz-Cordovés Rego G, Muñoz-Becerra L, Ramírez-García T, Lisbona-Montañez JM, Manrique-Arija S, Mucientes A, Núñez-Cuadros E, Galindo Zavala R, Serrano-Castro PJ, Fernández-Nebro A. Longitudinal Study of Cognitive Functioning in Adults with Juvenile Idiopathic Arthritis. Biomedicines 2022; 10:biomedicines10071729. [PMID: 35885032 PMCID: PMC9312867 DOI: 10.3390/biomedicines10071729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. Patients and methods: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline in cognitive function defined as a worsening of ≥2 points on the scales of the subsets administered to evaluate the different cognitive areas using the Wechsler Adult Intelligence Scale (WAIS) after 24 months: attention/concentration (digit span); verbal function (vocabulary); visual-spatial organization (block design); working memory (letter-number sequencing); and problem solving (similarities). Other variables included average inflammatory activity using C-reactive protein and composite activity indexes, comorbidity, and treatment. Logistic regression was performed to identify factors associated with cognitive decline. Results: The study population comprised 52 patients with JIA. Of these, 15 (28.8%) had cognitive decline at V24. The most affected functions were working memory (17.3%), attention/concentration (9.6%), verbal function (7.7%), visual-spatial organization (7.7%), and problem solving (3.8%). There were no significant differences in the median direct or scale scores for the cognitive functions evaluated between V0 and V24 for the whole sample. The factors associated with cognitive decline in patients with JIA were average C-reactive protein (OR [95% CI], 1.377 [1.060–1.921]; p = 0.039), depression (OR [95% CI], 3.691 [1.294–10.534]; p = 0.015), and treatment with biologics (OR [95% CI], 0.188 [0.039–0.998]; p = 0.046). Conclusion: Cognitive decline was detected in almost one third of adults with JIA after 24 months of follow-up. Systemic inflammatory activity in JIA patients was related to cognitive decline. Patients treated with biologics had a lower risk of decline in cognitive functions.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
- Correspondence: ; Tel.: +34-951291135
| | | | - Gisela Diaz-Cordovés Rego
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Luis Muñoz-Becerra
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
| | - Teresa Ramírez-García
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
| | - Jose Manuel Lisbona-Montañez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Sara Manrique-Arija
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Arkaitz Mucientes
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Esmeralda Núñez-Cuadros
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Pediatría, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Rocío Galindo Zavala
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Pediatría, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Pedro Jesús Serrano-Castro
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
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Marotte H, Fakra E, Flipo RM, Schaeverbeke T, Kabir-Ahmadi M, Gossec L, Lévy-Weil FE. Improvement in patient-reported outcomes in rheumatoid arthritis patients treated with sarilumab is independent of the cognition levels. Joint Bone Spine 2022; 89:105425. [PMID: 35716881 DOI: 10.1016/j.jbspin.2022.105425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Hubert Marotte
- Rheumatology Department and CIC 1408, University Hospital of Saint Étienne, Saint-Étienne, France; SAINBIOSE INSERM, 1059, University of Lyon, Saint-Étienne, France.
| | - Eric Fakra
- INSERM U1028 - CNRS UMR 5292, Lyon Neuroscience Research Centre, PSYR2 Team, Lyon, France; Psychiatry Department, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - René-Marc Flipo
- Rheumatology Department, University Hospital of Lille, Lille, France
| | | | | | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Rheumatology Department, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
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15
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Hasan MA, Vuckovic A, Qazi SA, Yousuf Z, Shahab S, Fraser M. Immediate effect of neurofeedback training on the pain matrix and cortical areas involved in processing neuropsychological functions. Neurol Sci 2021; 42:4551-4561. [PMID: 33624179 DOI: 10.1007/s10072-021-05125-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated the impact of neurofeedback training on the deeper cortical structures that comprise the "pain matrix" and are involved in processing neuropsychological functions. METHODS Five paraplegic patients with central neuropathic pain received up to 40 sessions of neurofeedback training. They were asked to simultaneously modulate the relative power of the theta, alpha and beta bands, provided as a feedback from the sensorimotor cortex. The source localization technique was applied on EEG data recorded with 16 electrodes placed over the whole head. RESULTS Neurofeedback training from the sensorimotor cortex induced effects on the pain matrix and in the areas involved in processing neuropsychological functions such as memory, executive functions and emotional regulations. Alpha and beta band activity was most increased in insular, cingulate and frontal cortex regions, and other areas corresponding to executive and emotional function processing. Theta band decreases were noted in the frontal, cingulate and motor cortices. In group analysis, theta and beta band activity was significantly reduced. CONCLUSION The single channel electroencephalogram-based neurofeedback training produced effects on similar areas that are targeted in 19 channels standardized low-resolution brain electromagnetic tomography and expensive time-delayed functional magnetic resonance imaging feedback studies.
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Affiliation(s)
- Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan. .,Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan.
| | - Aleksandra Vuckovic
- Centre for Rehabilitation Engineering, Biomedical Engineering Division, School of Engineering, University of Glasgow, Glasgow, UK
| | - Saad A Qazi
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan.,Department of Electrical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Zuha Yousuf
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan.,Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan.,Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - Sania Shahab
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Matthew Fraser
- Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, UK
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Turner KM, Wilcox G, Nordstokke DW, Dick B, Schroeder M, Noel M. Executive Functioning in Youth With and Without Chronic Pain: A Comparative Analysis. Clin J Pain 2021; 37:102-117. [PMID: 33165021 DOI: 10.1097/ajp.0000000000000895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Preliminary research in youth with chronic pain suggests differences in attention and working memory, which has been similarly demonstrated in adults with chronic pain. There has been little research on other aspects of executive functioning (EF) in this population despite its critical role in problem solving, school functioning, and coping. This study aimed to examine differences in several aspects of EF between youth with chronic pain and a nonchronic pain comparison group using performance-based neuropsychological tests and a behavior rating scale. MATERIALS AND METHODS Participants completed ratings of pain; physical, emotional, social, and school functioning; sleep quality; medication; and a general intelligence screener. Standardized neuropsychological tests were used to examine EF with a focus on working memory, divided and alternating attention, inhibition, flexibility, incidental memory, and planning. A parent-report and self-report behavior rating of EF was also administered. RESULTS Recruitment from 2 tertiary-care pain clinics resulted in a sample of 26 youth with chronic pain (80.8% girls) and their parents. A comparison group of 30 youth without chronic pain and their parents were recruited from the community. Participants with chronic pain had significantly lower scores on several performance-based tests of working memory/divided attention, inhibition, and flexibility/alternating attention than the comparison group. Statistically significant group differences were also found on behavior ratings of emotion control, shifting, task initiation and completion, working memory, planning and organization, overall emotion and cognitive regulation as well as global EF. Covariate analysis was conducted in all analyses where there were significant group differences and several observed group differences remained. DISCUSSION This study is one of few multidimensional examinations of EF in youth with chronic pain, using a comprehensive neuropsychological test battery combined with behavior ratings. Our findings suggest EF differences in youth with chronic pain, across a variety of domains and may suggest risk for specific cognitive processing weaknesses in this population. Medical and educational teams should work toward identification, treatment, and compensatory support for EF within individualized pain management for youth.
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Affiliation(s)
- Kailyn M Turner
- Werklund School of Education, Educational Psychology
- Alberta Children's Hospital Research Institute, Alberta Children's Hospital
| | - Gabrielle Wilcox
- Werklund School of Education, Educational Psychology
- Hotchkiss Brain Institute
- Alberta Children's Hospital Research Institute, Alberta Children's Hospital
- Mathison Centre for Mental Health Research & Education, Calgary, AB
| | | | - Bruce Dick
- Departments of Anesthesiology & Pain Medicine
- Psychiatry
- Pediatrics, University of Alberta, Edmonton, AB, Canada
| | | | - Melanie Noel
- Hotchkiss Brain Institute
- Department of Psychology, University of Calgary, Calgary
- Alberta Children's Hospital Research Institute, Alberta Children's Hospital
- Mathison Centre for Mental Health Research & Education, Calgary, AB
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Jastrowski Mano KE, Beckmann EA, Fussner LM, Kashikar-Zuck S. Executive Functioning in Adolescents with Chronic Musculoskeletal Pain. CHILDREN-BASEL 2020; 7:children7120273. [PMID: 33291625 PMCID: PMC7761892 DOI: 10.3390/children7120273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
Adolescents with chronic pain often suffer significant impairment in physical, emotional, and social domains. Surprisingly little is known about executive functioning (EF) in youth with chronic pain or how EF deficits may contribute to functional impairment. Study participants included 60 adolescents between the ages of 12 and 17 years (M = 14.57). Thirty participants with chronic musculoskeletal pain and 30 age- and gender-matched healthy controls were recruited from a large Midwestern children's hospital in the United States. Participants completed the Behavior Rating Inventory of Executive Functioning (BRIEF-2) as well as multiple measures of functional impairment across key domains: school, social, emotional (anxiety, depression), and physical. Adolescents with chronic musculoskeletal pain reported significantly greater EF impairment compared to healthy age- and gender-matched peers. Clinically elevated risk levels of impairment were reported across all aspects of EF, with many adolescents in the chronic pain group scoring above the clinical risk cut off for working memory (52%), inhibition (45%), and cognitive flexibility (38%). EF was also significantly related to functional impairment across all domains. Findings suggest that EF may have an impact across several critical domains of functioning for youth with chronic pain.
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Affiliation(s)
| | - Emily A. Beckmann
- Department of Psychology, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Lauren M. Fussner
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - Susmita Kashikar-Zuck
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH 45221, USA;
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18
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Mena-Vázquez N, Cabezudo-García P, Ortiz-Márquez F, Díaz-Cordovés Rego G, Muñoz-Becerra L, Manrique-Arija S, Fernández-Nebro A. Evaluation of cognitive function in adult patients with juvenile idiopathic arthritis. Int J Rheum Dis 2020; 24:81-89. [PMID: 33112486 DOI: 10.1111/1756-185x.14009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/08/2020] [Accepted: 10/04/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate cognitive function in adult patients with juvenile idiopathic arthritis (JIA) and associated factors. PATIENTS AND METHODS We performed a cross-sectional observational study of adult patients with JIA and a healthy control group (no inflammatory diseases) matched for age, gender, and educational level. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. The cognitive domains measured were attention/concentration, verbal function, visuospatial organization, working memory, and problem solving (Similarities). Other measures included clinical-epidemiological characteristics, comorbid conditions, and treatment. We performed a descriptive bivariate analysis and logistic regression to identify factors associated with visuospatial involvement. RESULTS The study population comprised 104 subjects (52 with JIA and 52 healthy controls). Patients with JIA had poorer results for visuospatial function, with a lower median scaled score on the Block Design test (5.0 [4.0-8.0] vs 8.0 [5.0-10.0]; P = .014). The number of patients with scaled scores below the average range (<8) in visuospatial organization was significantly greater in the JIA group (67.3% vs 40.4%; P = .006). The multivariate analysis revealed time since diagnosis (odds ratio [95% CI], 1.03 [1.01-1.06]), inflammatory activity according to Juvenile Arthritis Disease Activity Score 27-joint count (1.94 [1.01-3.75]), and educational level (0.28 [0.08-0.94]) to be factors associated with visuospatial function. CONCLUSION Cognitive function in adult patients with JIA is poorer than in healthy controls at the expense of visuospatial function. Visuospatial function in JIA patients was inversely associated with disease duration, inflammatory activity, and lower educational level.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Gisela Díaz-Cordovés Rego
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Luis Muñoz-Becerra
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain.,Departamento de Medicina, Universidad de Málaga, Málaga, Spain
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Yuen K, Bingham K, Tayer-Shifman OE, Touma Z. Measures of Cognition in Rheumatic Diseases. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:660-675. [PMID: 33091255 DOI: 10.1002/acr.24364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/19/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Kimberley Yuen
- Queen's University School of Medicine, Kingston, Ontario, Canada
| | | | | | - Zahi Touma
- Centre for Prognosis in Rheumatic Disease, Toronto Lupus Clinic, and University of Toronto, Toronto, Ontario, Canada
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20
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Shigihara Y, Hoshi H, Fukasawa K, Ichikawa S, Kobayashi M, Sakamoto Y, Negishi K, Haraguchi R, Konno S. Resting-State Magnetoencephalography Reveals Neurobiological Bridges Between Pain and Cognitive Impairment. Pain Ther 2020; 10:349-361. [PMID: 33095348 PMCID: PMC8119570 DOI: 10.1007/s40122-020-00213-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/15/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Pain has been identified as a risk factor for cognitive dysfunction, which in turn affects pain perception. Although pain, cognitive dysfunction, and their interaction are clinically important, the neural mechanism connecting the two phenomena remains unclear. Methods The resting-state brain activity of 38 participants was measured using magnetoencephalography before and after the patients underwent selective nerve root block (SNRB) for the treatment of their pain. We then assessed the extent to which these data correlated with the subjective levels of pain experienced by the patients across SNRB based on the visual analogue scale and the cognitive status of the patients measured after SNRB using the Japanese versions of the Mini-Mental State Examination (MMSE-J). Results Slow oscillations (delta) in the right precentral gyrus, right middle temporal gyrus, and left superior frontal gyrus were negatively correlated with the subjective level of pain, and fast oscillations (gamma) in the right insular cortex and right middle temporal gyrus before SNRB were negatively correlated with the MMSE-J score afterwards. These correlations disappeared after SNRB. Conclusion The presently observed changes in neural activity, as indicated by oscillation changes, might represent the transient bridge between pain and cognitive dysfunction in patients with severe pain. Our findings underscore the importance of treating pain before a transient diminishment of cognitive function becomes persistent.
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Affiliation(s)
- Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan. .,Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan.
| | - Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan
| | | | - Sayuri Ichikawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, Japan
| | - Momoko Kobayashi
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| | - Yuki Sakamoto
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| | | | - Rika Haraguchi
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, Japan
| | - Shin Konno
- Department of Orthopaedics, Kumagaya General Hospital, Kumagaya, Japan
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Petra CV, Visu-Petra L, Buta M, Tămaș MM, Benga O, Rednic S. A Computerized Assessment of Verbal and Visuospatial Memory (Dys)functions in Patients with Rheumatoid Arthritis. Psychol Res Behav Manag 2020; 13:619-629. [PMID: 32801959 PMCID: PMC7414973 DOI: 10.2147/prbm.s261312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/21/2020] [Indexed: 01/13/2023] Open
Abstract
Purpose Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease associated with various degrees of impairment across different cognitive domains. We aimed to provide a detailed computerized investigation of verbal and visuospatial short-term and working memory (dys)functions in RA patients, assessing both accuracy and response speed, while relating them to age, disease-related activity, affective problems, psychomotor speed and other clinical parameters. Patients and Methods The study included 29 RA patients (mean age 50.6 ± 12.3 years, 79% female) and 30 controls (matched according to age, gender and education), assessed with short-term and working memory tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Automated Working Memory Assessment (AWMA). Results RA patients were significantly slower on the basic processing speed test (Motor Screening Test, p =0.003). Their short-term information storage (verbal and visuospatial) was comparable to controls, yet this similar accuracy came at the expense of a longer response time to retain information correctly (on spatial span, p = 0.04). On tasks with higher executive demands, both visuospatial and verbal working memory were compromised, as RA patients took longer (p = 0.004) and had a higher number of total errors (p = 0.02) when conducting a strategic memory-guided search (Spatial Working Memory), and had a significantly lower verbal working memory span on the backwards digit recall test (p = 0.02). Conclusion The findings of this study emphasize the usefulness of performing computerized tests to detect subtle signs of cognitive impairment and of intact performance, which can inform memory training protocols for this vulnerable population.
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Affiliation(s)
- Cristian Vasile Petra
- Department of Rheumatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laura Visu-Petra
- Developmental Psychology Lab, Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Monica Buta
- Developmental Psychology Lab, Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Maria Magdalena Tămaș
- Department of Rheumatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Oana Benga
- Developmental Psychology Lab, Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Simona Rednic
- Department of Rheumatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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22
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Chaurasia N, Singh IL, Singh T, Tiwari T, Singh A. Effect of depression on attentional network system among rheumatoid arthritis patients-A cross-sectional study. J Family Med Prim Care 2020; 9:1974-1980. [PMID: 32670950 PMCID: PMC7346935 DOI: 10.4103/jfmpc.jfmpc_1161_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 12/21/2019] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, painful and debilitating musculoskeletal condition with depression being its common co-morbidity. It is associated with symptoms of fatigue, pain, and sleep disturbances that can overlap with or mimic symptoms of depression. It may occur with at least mild severity is up to 42% of RA patients. Basically, depression refers to a constellation of experience including not only mood but also physical, mental and behavioral experiences. The fact that rates of depression are higher in samples of patients with RA than in the normal population is well documented. The present study was conducted in order to examine the effect of depression on attentional functioning with diagnosed RA patients. Twenty RA patients out of which 10 patients with depression and 10 patients without depression participated in the study. The Beck Depression Inventory was administered for the assessment of depression and the attentional network task was used to measure the attentional performance of the RA patients. Results revealed that there was a significant difference in depressive symptoms among RA patients on accuracy and reaction time (P < 0.01) and orienting effect (P < 0.05). The findings would also imply intervention and rehabilitation of depression among RA patients.
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Affiliation(s)
- Neha Chaurasia
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Indramani L Singh
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Tara Singh
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Trayambak Tiwari
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Anup Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Chaurasia N, Singh A, Singh IL, Singh T, Tiwari T. Cognitive dysfunction in patients of rheumatoid arthritis. J Family Med Prim Care 2020; 9:2219-2225. [PMID: 32754477 PMCID: PMC7380780 DOI: 10.4103/jfmpc.jfmpc_307_20] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/19/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022] Open
Abstract
Rheumatoid Arthritis (RA) is a form of arthritis characterized by joint pain, stiffness, swelling and deformity. There has been plethora of researches in the area of rheumatoid arthritis which focused on immune system, genetic predisposition and newer treatment modalities. Researchers have also examined the cognitive decline, physical deficits and their interrelationship in patients with RA. Among several psychological aspects depression, anxiety and stress emerge as significant psychological co morbidity. RA is a multifactorial, chronic, inflammatory disease primarily affects physical functioning as well as psychological aspects. Pain, fatigue, duration of disease, disease activity and functional disability are very common in rheumatoid arthritis which is leading cause of psychological distress and functional disability. Various types of neuropsychological battery were used to assess the decline in specific areas like attention, executive functioning, visuo-spatial learning, verbal learning/memory etc. These functions were compared with other type of arthritis disease. Also, various other factors like depression, cardiovascular diseases, other systemic and chronic disease and concomitant drugs intake etc. also affected cognitive functioning in Rheumatoid Arthritis patients. The objective of this review was to identify and explore the rates and types of cognitive impairment in RA. This present review paper systematically examines and summarizes the cognition related decrement in arthritis patients. Multiple research articles between 1990 to 2018 were searched. These reviews were evaluated and synthesized using a narrative and descriptive approach.
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Affiliation(s)
- Neha Chaurasia
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Anup Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Indramani L Singh
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Tara Singh
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Trayambak Tiwari
- Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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24
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Oláh C, Kardos Z, Andrejkovics M, Szarka E, Hodosi K, Domján A, Sepsi M, Sas A, Kostyál L, Fazekas K, Flórián Á, Lukács K, Miksi Á, Baráth Z, Kerekes G, Péntek M, Valikovics A, Tamási L, Bereczki D, Szekanecz Z. Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety. Rheumatol Int 2019; 40:529-540. [PMID: 31555886 DOI: 10.1007/s00296-019-04449-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima-media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.
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Affiliation(s)
- Csaba Oláh
- Department of Neurosurgery, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Zsófia Kardos
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Mónika Andrejkovics
- Institute of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.,Department of Oncoradiology, Szabolcs-Szatmár-Bereg County Hospitals, Jósa András Teaching Hospital, Nyíregyháza, Hungary
| | - Enikő Szarka
- Department of Neurosurgery, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Katalin Hodosi
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Domján
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Mariann Sepsi
- Department of Radiology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Attila Sas
- Department of Neurology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - László Kostyál
- Department of Radiology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Katalin Fazekas
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Ágnes Flórián
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Katalin Lukács
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Ágnes Miksi
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Zsuzsanna Baráth
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - György Kerekes
- Department of Angiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University, Budapest, Hungary.,Department of Rheumatology, Flór Ferenc County Hospital, Kistarcsa, Hungary
| | - Attila Valikovics
- Department of Neurology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - László Tamási
- Department of Rheumatology, Borsod County Teaching Hospital, Miskolc, Hungary
| | - Dániel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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25
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Bunk S, Preis L, Zuidema S, Lautenbacher S, Kunz M. Executive Functions and Pain. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2019. [DOI: 10.1024/1016-264x/a000264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. A growing body of literature suggests that chronic-pain patients suffer from problems in various neuropsychological domains, including executive functioning. In order to better understand which components of executive functioning (inhibition, shifting and/or updating) might be especially affected by pain and which mechanisms might underlie this association, we conducted a systematic review, including both chronic-pain studies as well as experimental-pain studies. The chronic-pain studies (N = 57) show that pain is associated with poorer executive functioning. The findings of experimental-pain studies (N = 28) suggest that this might be a bidirectional relationship: Pain can disrupt executive functioning, but poorer executive functioning might also be a risk factor for higher vulnerability to pain.
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Affiliation(s)
- Stefanie Bunk
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | - Lukas Preis
- Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | | | - Miriam Kunz
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
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26
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Deleterious Impact of Expressive Suppression on Test Performance Persists at One-Year Follow-Up in Community-Dwelling Older Adults. J Int Neuropsychol Soc 2019; 25:29-38. [PMID: 30362445 DOI: 10.1017/s1355617718000838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Expressive suppression (ES) is an emotion-regulation strategy that is associated with poorer performance on subsequently administered tests of executive functioning (EF). It is not known, however, how far into the future ES interferes with EF. This study examined whether (a) ES negatively affects performance on EF tests repeated 1 year after the initial administration (presumably through interference with learning, leading to a reduced practice effect), and (b) whether such an effect, if seen, is unique to EF or whether it also affects lower-order cognitive processes needed for EF test performance. METHODS Sixty-six non-demented community-dwelling older adults were randomly assigned to either an ES group or control group. Executive and non-executive tests were administered before and immediately following the exposure to an emotionally evocative video, and then again at 1-year follow-up. Groups were compared at 1-year follow-up on tests of EF and lower-order processes, to examine whether the previously demonstrated impact of ES on EF is evident only immediately following the experimental manipulation (Franchow & Suchy, 2017), or also at 1-year follow-up. RESULTS The results showed that participants who engaged in ES continued to exhibit poorer performance on EF tests 1 year later. This effect was not present for performance on tests of lower-order processes. CONCLUSIONS These results suggest that the use of ES before an EF task can interfere with the ability to benefit from exposure to that task, thereby negatively affecting future performance. (JINS, 2019, 25, 29-38).
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27
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Higgins DM, Martin AM, Baker DG, Vasterling JJ, Risbrough V. The Relationship Between Chronic Pain and Neurocognitive Function: A Systematic Review. Clin J Pain 2018; 34:262-275. [PMID: 28719507 PMCID: PMC5771985 DOI: 10.1097/ajp.0000000000000536] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Understanding the relationship between chronic pain and neurocognition has important implications for the assessment and treatment of patient experiencing pain. This paper provides an overview of the current literature examining the neurocognition-chronic pain relationship and suggests future avenues of research, along with a discussion of clinical implications of the literature findings. Consideration of potential moderators and mediators of this relationship, as well as a brief discussion of the importance of future research in special populations at particular risk for these problems, are also a focus of this paper. METHODS This systematic review summarizes the findings of clinical studies in which neurocognitive performance was measured in chronic pain samples. A literature search led to the inclusion of 53 articles in the review. RESULTS Studies of neurocognitive performance in clinical chronic pain samples support a relationship between chronic pain and neurocognitive abnormalities, particularly on tests of memory, attention, and processing speed, with mixed data regarding executive functioning. DISCUSSION Several factors may moderate or mediate the relationship between chronic pain and neurocognitive functioning, including mood symptoms, medication side effects, and intensity and/or chronicity of pain. Limitations in the literature include a paucity of methodologically rigorous studies controlling for confounding variables (eg, opioid analgesia) and a limited number of studies examining the relationship between chronic pain and traumatic brain injury (a potential precipitant of both pain and neurocognitive impairment). Nonetheless, findings from the existing literature have significant clinical implications, including for populations with heightened risk of both pain and neurocognitive disorders.
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Affiliation(s)
- Diana M. Higgins
- VA Boston Healthcare System, Boston, MA
- Boston University School of Medicine, Boston, MA
| | | | - Dewleen G. Baker
- University of California San Diego, San Diego, CA
- VA Center of Excellence for Stress and Mental Health and San Diego Healthcare System, San Diego, CA
| | | | - Victoria Risbrough
- University of California San Diego, San Diego, CA
- VA Center of Excellence for Stress and Mental Health and San Diego Healthcare System, San Diego, CA
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28
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Meade T, Manolios N, Cumming SR, Conaghan PG, Katz P. Cognitive Impairment in Rheumatoid Arthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2017; 70:39-52. [DOI: 10.1002/acr.23243] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/21/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Tanya Meade
- Western Sydney University and University of Sydney; Sydney New South Wales Australia
| | | | | | - Philip G. Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; University of Leeds, and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit; Leeds UK
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29
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Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis. Rheumatol Int 2017; 37:1635-1641. [PMID: 28871379 DOI: 10.1007/s00296-017-3806-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Abstract
This study explored the discrepancy between perceived cognitive dysfunction and computerized neuropsychological test performance in Korean patients with RA. Individuals with RA were recruited by their rheumatologists during follow-up visits at one hospital in Korea. After getting signed consents, a trained research nurse assessed participants with a range of physical, psychosocial, and biological metrics. Subjective cognitive dysfunction was assessed using the Perceived Deficits Questionnaire (PDQ; range 0-20). Objective cognitive impairment was assessed using a set of 6 computerized neurocognitive tests yielding 12 indices covering a range of cognitive domains. Subjects were classified as 'impaired' if they performed 1 SD below age-based population norms on each test. A total cognitive function score was calculated by summing the transformed scores (range 0-12). Multiple linear regression analyses determined the relationship of total cognitive function score with PDQ score, controlling for disease activity, functional limitations, and psychological factors. Forty subjects (mean ± SD age: 63.1 ± 11.4 years) were included. Mean ± SD scores of total cognitive function and PDQ were 7.3 ± 2.7 (2-12) and 11.8 ± 5.1 (5-25), respectively. In multivariate analysis, there was no significant relationship between total cognitive function score and PDQ score. However, depression and sleep quality (β = 0.37, p = 0.025; β = 0.17, p = 0.034) were significantly associated with PDQ score. The findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors within the context of cognitive complaints in clinical settings.
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30
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Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls. Qual Life Res 2017; 26:2449-2457. [DOI: 10.1007/s11136-017-1604-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
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31
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Attention and Working Memory in Female Adolescents With Chronic Pain and Pain-free Female Adolescents: A Preliminary Pilot Study. Clin J Pain 2017; 32:609-16. [PMID: 27275532 DOI: 10.1097/ajp.0000000000000239] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Adolescents with chronic pain often report inattention and poor memory. There has been little research on cognitive function in this population. The goal of this preliminary pilot study was to examine differences in cognitive function between adolescents with chronic pain to pain-free adolescents. MATERIALS AND METHODS All participants completed baseline assessments of pain, school absences, depression, anxiety, and sleep habits. Standardized neurocognitive tests were used to examine cognitive function with a focus on working memory and attention. RESULTS Recruitment from the chronic pain clinic resulted in a female sample of 13 individuals (largely reflective of the clinical population). Pain-free age-matched and sex-matched individuals (n=12) were therefore also recruited as controls. Individuals with chronic pain had significantly lower working memory scores than controls. Differences were found between groups on the most difficult selective attention task and not on tests of sustained attention, divided attention, or attentional switching. In a stepwise regression with baseline characteristics entered in the first step, pain accounted for approximately 15% of the variance in working memory and medication score counted for 49% of the variance. DISCUSSION This pilot study is the first study to examine differences in working memory and attention between participants with chronic pain and pain-free adolescents. Our findings suggest that chronic pain may negatively affect adolescents' working memory function and highlights the risk for cognitive difficulties and problems with educational progression in addition to negative health and social effects associated with chronic pain. The study provides a starting point for more research and has the potential to direct better identification and treatment of these cognitive deficits.
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32
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Bjekić J, Živanović M, Purić D, Oosterman JM, Filipović SR. Pain and executive functions: a unique relationship between Stroop task and experimentally induced pain. PSYCHOLOGICAL RESEARCH 2017; 82:580-589. [DOI: 10.1007/s00426-016-0838-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
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Simos P, Ktistaki G, Dimitraki G, Papastefanakis E, Kougkas N, Fanouriakis A, Gergianaki I, Bertsias G, Sidiropoulos P, Karademas EC. Cognitive deficits early in the course of rheumatoid arthritis. J Clin Exp Neuropsychol 2016; 38:820-9. [PMID: 27133019 DOI: 10.1080/13803395.2016.1167173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim was to examine the severity and prevalence of cognitive difficulties in persons with rheumatoid arthritis (RA) within the first three years of diagnosis. METHOD One hundred consecutive RA patients aged 28-67 years (90% women) were administered a battery of 6 neuropsychological tests yielding 14 cognitive indices. Self-reported measures of trait anxiety, depression, impact of disease on daily activities, and pain severity were also obtained along with physician-rated disease severity. RESULTS Twenty percent of RA patients were classified as cognitively impaired, defined as age- and education-adjusted scores at least 1.5 standard deviations below the population mean on 3 or more cognitive indices. Impaired performance, controlling for age, education, and premorbid cognitive capacity, was detected primarily on measures of short-term memory, immediate and delayed episodic recall, and phonemic fluency. There were modest negative associations between cognitive indices and measures of perceived disease severity (pain level, impact of disease on daily functionality, and overall health quality). CONCLUSIONS Cognitive deficits on several domains are frequently encountered in relatively young RA patients during the first few years of the disease and may need to be taken into account as important correlates of disease severity and progression.
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Affiliation(s)
- Panagiotis Simos
- a Medical School , University of Crete , Iraklion , Crete , Greece
| | - Georgia Ktistaki
- a Medical School , University of Crete , Iraklion , Crete , Greece
| | - Georgia Dimitraki
- b Department of Psychology , University of Crete , Iraklion , Crete , Greece
| | | | - Nikolaos Kougkas
- a Medical School , University of Crete , Iraklion , Crete , Greece
| | | | - Irini Gergianaki
- a Medical School , University of Crete , Iraklion , Crete , Greece
| | - George Bertsias
- a Medical School , University of Crete , Iraklion , Crete , Greece
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Ojeda B, Failde I, Dueñas M, Salazar A, Eccleston C. Methods and Instruments to Evaluate Cognitive Function in Chronic Pain Patients: A Systematic Review. PAIN MEDICINE 2015; 17:1465-89. [PMID: 26814300 DOI: 10.1093/pm/pnv077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 10/30/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to systematically review the methods and instruments used to evaluate cognitive function in chronic pain (CP) patients. METHODS A sensitive search strategy was designed using five databases. Based on the objectives and methodology, we selected cross-sectional studies on adults with chronic non-cancer pain in which cognitive function was assessed using validated instruments. The characteristics of the subjects, control groups, and other variables that might affect cognitive function, and the instruments used, were extracted from each article. RESULTS In the 42 articles identified, 53 instruments were used to assess cognitive function. Chronic pain criteria were defined in 83.3% of the articles and more than half (57.1%) included single diagnosis samples, with fibromyalgia being the most frequent studied (75%). Patients with prior cognitive impairment were excluded in 61.9% of the studies, and a control group was included in 64.3% of the studies. In most cases potential confounding variables were evaluated. More than 14% of the studies used self-report measures, and 73.8% used neuropsychological instruments, particularly for assessing attention (30%) and memory (27.5%). None of the instruments were specifically validated for pain patients and only five studies analyzed the psychometric properties of the instruments. CONCLUSIONS Various instruments and methods were used to assess cognitive function in CP patients, particularly fibromyalgia patients, but also other cohorts with well-defined CP. The instruments used had been validated, but not for pain populations, thus they require specific adaptation and validation to be used in CP patients. Certain recommendations are made in order to improve the evaluation of cognitive function in these patients.
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Affiliation(s)
- Begoña Ojeda
- *Preventive Medicine and Public Health Area, The Observatory of Pain (External Chair of Pain), University of Cádiz, Cádiz, Spain
| | - Inmaculada Failde
- *Preventive Medicine and Public Health Area, The Observatory of Pain (External Chair of Pain), University of Cádiz, Cádiz, Spain
| | - María Dueñas
- Salus Infirmorum Faculty of Nursing, University of Cádiz, Spain
| | - Alejandro Salazar
- *Preventive Medicine and Public Health Area, The Observatory of Pain (External Chair of Pain), University of Cádiz, Cádiz, Spain
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Boggero IA, Eisenlohr-Moul T, Segerstrom SC. Task-switching ability protects against the adverse effects of pain on health: A longitudinal study of older adults. Br J Health Psychol 2015; 21:434-50. [PMID: 26688002 DOI: 10.1111/bjhp.12178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 11/11/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Ageing is often accompanied by increases in pain, which may threaten physical health. Successfully managing increased pain requires the ability to switch attention away from the pain and towards adaptive health cognitions and behaviours. However, no study to date has tested how pain interacts with task-switching ability to predict future health in older adults. Additionally, no study has tested whether objective (i.e., task-switching performance) or subjective measures of cognitive ability have a stronger impact on future health. DESIGN/METHODS The current study tested these interactions in community-dwelling older adults. Participants included 150 older adults who provided pain, task-switching ability, subjective cognitive functioning, and health data every 6 months for up to 5 years. RESULTS Multilevel modelling was used to analyse the data, yielding gammas (γ) analogous to unstandardized beta weights in regression. A significant interaction between task-switching and pain indicated that when task-switching ability was lower than usual, higher-than-usual pain predicted poorer health at the following wave (γ = 0.30, SE = 0.12, t(663) = 2.45, p = .009; 95% CI: 0.07-0.65). When task-switching ability was higher than usual, there was no effect of pain on health (γ = -0.13, t(663) = -0.85, p = .39; 95% CI: -0.44-0.17). No significant interaction was found for subjective cognitive functioning. CONCLUSIONS Objective task-switching ability, but not subjective cognitive functioning, may have health-protective effects when older adults experience increases in pain. STATEMENT OF CONTRIBUTION What is already known on the subject? As people age, they are more likely to experience pain. Increases in pain threaten health. Older adults are at particular risk for both increased pain and poor health. What does this study add? When pain levels are higher than usual, task-switching ability protects older adults from future declines in health. Within people, task-switching ability interacts with pain to promote healthy ageing.
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Affiliation(s)
- Ian A Boggero
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, University of Kentucky, University of North Carolina at Chapel Hill, Medical School Wing D, Chapel Hill, North Carolina, USA
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Zhao S, Chen Y, Chen H. Sociodemographic factors associated with functional disability in outpatients with rheumatoid arthritis in Southwest China. Clin Rheumatol 2015; 34:845-51. [PMID: 25687985 DOI: 10.1007/s10067-015-2896-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/29/2015] [Accepted: 02/04/2015] [Indexed: 02/05/2023]
Abstract
With the rising number of patients with rheumatoid arthritis (RA), there is a limited understanding about sociodemographic factors that influence functional disability in Chinese patients. In order to provide more targeted interventions to improve health-related quality of life (HRQoL) for patients with RA, we conducted a cross-sectional study to investigate the level and influencing factors of functional disability. Convenient samples were collected in outpatients with RA from a rheumatological center in southwest China from September to December 2013. Data were collected by printed questionnaires, and functional disability was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). The results showed that 58.48 % of 607 outpatients had functional disability. Patients from rural residents, with lower household income and lower education level, were significantly associated with worse functional disability. Multivariate regression findings showed that pain, age, disease duration, total cost for treatment, and frequency of hospitalization were positively associated with functional disability. Meanwhile, subjective and available social support was the protective predictors for functional disability. The results suggested that systematic intervention and therapies should be provided as early as possible. Patients and health care providers should promote the awareness of the importance of accessible health education in early intervention of RA. Besides, pain management and social support are encouraged to postpone the process of disability of patients and improve the HRQoL. Lastly, but not least, prevention and intervention of RA should be incorporated into public health education.
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Affiliation(s)
- Shangping Zhao
- West China School of Nursing & Department of Nursing, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, Sichuan, 610041, People's Republic of China
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Investigating the Modality and Redundancy Effects for Learners with Persistent Pain. EDUCATIONAL PSYCHOLOGY REVIEW 2014. [DOI: 10.1007/s10648-014-9293-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Tapscott BE, Etherton J. The Effects of Cold Pressor-Induced Pain on PASAT Performance. APPLIED NEUROPSYCHOLOGY-ADULT 2014; 22:227-32. [DOI: 10.1080/23279095.2014.910213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Brian E. Tapscott
- Department of Psychology, The University of Rhode Island, Kingston, Rhode Island
| | - Joseph Etherton
- Department of Psychology, Texas State University, San Marcos, Texas
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Arslanian-Engoren C, Giordani BJ, Algase D, Schuh A, Lee C, Moser DK. Cognitive Dysfunction in Older Adults Hospitalized for Acute Heart Failure. J Card Fail 2014; 20:669-78. [DOI: 10.1016/j.cardfail.2014.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 05/16/2014] [Accepted: 06/06/2014] [Indexed: 10/25/2022]
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Hess LE, Haimovici A, Muñoz MA, Montoya P. Beyond pain: modeling decision-making deficits in chronic pain. Front Behav Neurosci 2014; 8:263. [PMID: 25136301 PMCID: PMC4117932 DOI: 10.3389/fnbeh.2014.00263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/14/2014] [Indexed: 11/13/2022] Open
Abstract
Risky decision-making seems to be markedly disrupted in patients with chronic pain, probably due to the high cost that impose pain and negative mood on executive control functions. Patients’ behavioral performance on decision-making tasks such as the Iowa Gambling Task (IGT) is characterized by selecting cards more frequently from disadvantageous than from advantageous decks, and by switching often between competing responses in comparison with healthy controls (HCs). In the present study, we developed a simple heuristic model to simulate individuals’ choice behavior by varying the level of decision randomness and the importance given to gains and losses. The findings revealed that the model was able to differentiate the behavioral performance of patients with chronic pain and HCs at the group, as well as at the individual level. The best fit of the model in patients with chronic pain was yielded when decisions were not based on previous choices and when gains were considered more relevant than losses. By contrast, the best account of the available data in HCs was obtained when decisions were based on previous experiences and losses loomed larger than gains. In conclusion, our model seems to provide useful information to measure each individual participant extensively, and to deal with the data on a participant-by-participant basis.
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Affiliation(s)
- Leonardo Emanuel Hess
- Training and Research for Argentina Medical Association (CIMA), Faculty of Medical Sciences, National University of Rosario (UNR) Rosario, Santa Fe, Argentina ; Research Institute on Health Sciences (IUNICS), University of Balearic Islands (UIB) Palma, Spain
| | - Ariel Haimovici
- Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires Física, Buenos Aires, Argentina ; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) Buenos Aires, Argentina
| | - Miguel Angel Muñoz
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands (UIB) Palma, Spain ; Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, University of Granada Granada, Spain
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands (UIB) Palma, Spain
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Smith A, Ayres P. The Impact of Persistent Pain on Working Memory and Learning. EDUCATIONAL PSYCHOLOGY REVIEW 2013. [DOI: 10.1007/s10648-013-9247-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Timing and gender determine if acute pain impairs working memory performance. THE JOURNAL OF PAIN 2013; 14:1320-9. [PMID: 23972353 DOI: 10.1016/j.jpain.2013.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 05/16/2013] [Accepted: 05/27/2013] [Indexed: 11/21/2022]
Abstract
UNLABELLED The effects of pain on memory are complex, and little is known about the vulnerability of working memory (WM) performance when individuals complete a WM test while concurrently experiencing pain. Here, we subjected 78 healthy nonsmoking participants to either acute pain or a control condition while we administered a WM test. In this context, we also tested WM 20 minutes after pain in order to determine if timing of pain affected WM performance, and assessed objective and subjective measures of pain. We hypothesized that pain would impair WM performance during pain. Further, women's WM performance would be impaired more than men. Importantly, there was an interaction between gender and condition, with women exposed to pain experiencing impairments during but not after the cold pressor task. Our data imply that timing and gender are critically important in whether acute pain is costly to WM performance. Our findings have interesting clinical, professional, and educational implications, and understanding the influence of pain could help to improve the interpretation of WM tests in these diverse settings. PERSPECTIVE Results of this study support the growing body of work that attests to the detrimental effect of pain on WM performance. Further, this study provides new evidence that concurrently experiencing cold pressor pain impairs WM in regularly menstruating women and women taking a contraceptive.
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Akdoğan S, Ayhan FF, Yıldırım Ş, Borman P. Impact of Fatigue on Cognitive Functioning among Premenopausal Women with Fibromyalgia Syndrome and Rheumatoid Arthritis: The Controlled Study. ACTA ACUST UNITED AC 2013. [DOI: 10.3109/10582452.2013.806977] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nakae A, Endo K, Adachi T, Ikeda T, Hagihira S, Mashimo T, Osaka M. The influence of working memory capacity on experimental heat pain. THE JOURNAL OF PAIN 2013; 14:1088-96. [PMID: 23773342 DOI: 10.1016/j.jpain.2013.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 04/06/2013] [Accepted: 04/12/2013] [Indexed: 11/30/2022]
Abstract
UNLABELLED Pain processing and attention have a bidirectional interaction that depends upon one's relative ability to use limited-capacity resources. However, correlations between the size of limited-capacity resources and pain have not been evaluated. Working memory capacity, which is a cognitive resource, can be measured using the reading span task (RST). In this study, we hypothesized that an individual's potential working memory capacity and subjective pain intensity are related. To test this hypothesis, we evaluated 31 healthy participants' potential working memory capacity using the RST, and then applied continuous experimental heat stimulation using the listening span test (LST), which is a modified version of the RST. Subjective pain intensities were significantly lower during the challenging parts of the RST. The pain intensity under conditions where memorizing tasks were performed was compared with that under the control condition, and it showed a correlation with potential working memory capacity. These results indicate that working memory capacity reflects the ability to process information, including precise evaluations of changes in pain perception. PERSPECTIVE In this work, we present data suggesting that changes in subjective pain intensity are related, depending upon individual potential working memory capacities. Individual working memory capacity may be a phenotype that reflects sensitivity to changes in pain perception.
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Affiliation(s)
- Aya Nakae
- Department of Anesthesiology & Intensive Care, Osaka University Graduate School of Medicine, Osaka, Japan.
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Dima AL, Gillanders DT, Power MJ. Dynamic pain–emotion relations in chronic pain: a theoretical review of moderation studies. Health Psychol Rev 2013. [DOI: 10.1080/17437199.2011.569937] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Shin SY, Katz P, Julian L. Relationship between perceived cognitive dysfunction and objective neuropsychological performance in persons with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2013; 65:481-6. [PMID: 22899659 DOI: 10.1002/acr.21814] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/27/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Research shows a gap between perceived cognitive dysfunction and objective neuropsychological performance in persons with chronic diseases. We explored this relationship in persons with rheumatoid arthritis (RA). METHODS Individuals from a longitudinal cohort study of RA participated in a study visit that included physical, psychosocial, cognitive, and biologic metrics. Subjective cognitive dysfunction was assessed using the Perceived Deficits Questionnaire (PDQ; range 0-20, where higher scores = greater perceived impairment). Objective cognitive impairment was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices. On each test, subjects were classified as impaired if they performed 1 SD below the age-based population norms. Total cognitive function scores were calculated by summing the transformed scores (range 0-16, where higher scores = greater impairment). Multiple linear regression analyses determined the relationship of the total cognitive function score with the PDQ score, controlling for sex, race, marital status, income, education, disease duration, disease severity, depression, and fatigue. RESULTS One hundred twenty subjects (mean ± SD age 58.5 ± 11.0 years) were included. Mean ± SD scores of total cognitive function and the PDQ were 2.5 ± 2.2 (range 0-10) and 5.8 ± 3.8 (range 0-16), respectively. In multivariate analysis, there was no significant relationship between the total cognitive function score and the PDQ score. However, depression and fatigue (β = 0.32, P < 0.001 and β = 0.31, P = 0.001, respectively) were significantly associated with the PDQ score. CONCLUSION The findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors within the context of cognitive symptoms in clinical settings.
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Shin SY, Julian L, Katz P. The relationship between cognitive function and physical function in rheumatoid arthritis. J Rheumatol 2013; 40:236-43. [PMID: 23322467 DOI: 10.3899/jrheum.120871] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA). METHODS Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as "impaired" if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as "impaired" (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties. RESULTS There were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: β = -0.24, p = 0.014; HAQ: β = 0.24, p = 0.003) but not with disability (VLA: β = 0.10, p = 0.207). CONCLUSION Cognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA.
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Affiliation(s)
- So Young Shin
- College of Nursing, Keimyung University, Daegu, South Korea.
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Meade T, Cumming S, Hallab L, Spencer D, Howe G, Manolios N. A preliminary investigation of cognitive function in rheumatoid arthritis patients on long-term methotrexate treatment. J Health Psychol 2012. [DOI: 10.1177/1359105312461660] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Some studies suggest that cognitive function is impaired in rheumatoid arthritis patients. One possible influence may be commonly used rheumatoid arthritis treatment, methotrexate. This study examined cognitive function in long-term methotrexate users with rheumatoid arthritis and, using a 24-hour pre- and post-methotrexate dose administration, investigated whether there may be transient cognitive function changes. Rheumatoid arthritis patients ( n = 35) were assessed immediately before taking methotrexate and 24 hours later. Low and high methotrexate dose groups were then compared. Cognitive performance was unchanged across two assessment points and was within the normal range, although lower in high methotrexate dose group.
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Affiliation(s)
- Tanya Meade
- University of Western Sydney, Australia
- University of Sydney, Australia
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Lee C, Crawford C, Wallerstedt D, York A, Duncan A, Smith J, Sprengel M, Welton R, Jonas W. The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews. Syst Rev 2012; 1:46. [PMID: 23067573 PMCID: PMC3534620 DOI: 10.1186/2046-4053-1-46] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 09/27/2012] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Co-morbid symptoms (for example, chronic pain, depression, anxiety, and fatigue) are particularly common in military fighters returning from the current conflicts, who have experienced physical and/or psychological trauma. These overlapping conditions cut across the boundaries of mind, brain and body, resulting in a common symptomatic and functional spectrum of physical, cognitive, psychological and behavioral effects referred to as the 'Trauma Spectrum Response' (TSR). While acupuncture has been shown to treat some of these components effectively, the current literature is often difficult to interpret, inconsistent or of variable quality. Thus, to gauge comprehensively the effectiveness of acupuncture across TSR components, a systematic review of reviews was conducted using the Samueli Institute's Rapid Evidence Assessment of the Literature (REAL©) methodology. METHODS PubMed/MEDLINE, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, and PsycInfo were searched from inception to September 2011 for systematic reviews/meta-analyses. Quality assessment was rigorously performed using the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Adherence to the Standards for Reporting Interventions in Clinical Trials in Acupuncture (STRICTA) criteria was also assessed. RESULTS Of the 1,480 citations identified by our searches, 52 systematic reviews/meta-analyses, all high quality except for one, met inclusion criteria for each TSR component except post-traumatic stress disorder (PTSD) and sexual function. The majority of reviews addressed most STRICTA components, but did not describe safety. CONCLUSIONS Based on the results of our review, acupuncture appears to be effective for treating headaches and, although more research is needed, seems to be a promising treatment option for anxiety, sleep disturbances, depression and chronic pain. It does not, however, demonstrate any substantial treatment benefit for substance abuse. Because there were no reviews on PTSD or sexual function that met our pre-defined inclusion criteria, we cannot comment on acupuncture's effectiveness in treating these conditions. More quality data are also needed to determine whether acupuncture is appropriate for treating fatigue or cognitive difficulties. Further, while acupuncture has been shown to be generally safe, safety was not described in the majority of studies, making it difficult to provide any strong recommendations. Future research should address safety reporting in detail in order to increase our confidence in acupuncture's efficacy across the identified TSR components.
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Affiliation(s)
- Courtney Lee
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA, USA.
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Shin SY. The Relationship Between Cognitive and Physical Function in Older Adults with Rheumatoid Arthritis: A Literature Review. J Gerontol Nurs 2012; 38:33-42. [DOI: 10.3928/00989134-20120807-03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 03/14/2012] [Indexed: 01/17/2023]
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