Neuropsychological functions of verbal recall and psychomotor speed significantly affect pain tolerance.

Autor: Jacobsen HB; Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.; Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway., Stubhaug A; Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.; Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway., Schirmer H; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Inge Landrø N; Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway.; National Competence Centre for Complex Symptom Disorders, St. Olavs University Hospital, Trondheim, Norway., Wilsgaard T; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Mathiesen EB; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.; Department of Neurology, University Hospital of North Norway, Tromsø, Norway., Nielsen CS; Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.; Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.; Division of Ageing and Health, Norwegian Institute of Public Health, Oslo, Norway.
Jazyk: angličtina
Zdroj: European journal of pain (London, England) [Eur J Pain] 2019 Oct; Vol. 23 (9), pp. 1608-1618. Date of Electronic Publication: 2019 Jul 29.
DOI: 10.1002/ejp.1437
Abstrakt: Background: Effects from cognitive performance on pain tolerance have been documented, however, sample sizes are small and confounders often overlooked. We aimed to establish that performance on neuropsychological tests was associated with pain tolerance, controlling for salient confounders.
Methods: This was a cross-sectional study nested within the Tromsø-6 survey. Neuropsychological test performance and the cold pressor test were investigated in 4,623 participants. Due to significant interaction with age, participants were divided into three age groups (<60, ≥60 to <70 and ≥70 years). Cox proportional hazard models assessed the relationship between neuropsychological tests and cold pressure pain tolerance, using hand-withdrawal as event. The fully adjusted models controlled for sex, education, BMI, smoking status, exercise, systolic blood pressure, sleep problems and mental distress.
Results: In the adjusted models, participants aged ≥70 years showed a decreased hazard of hand withdrawal of 18% (HR 0.82, 95% CI (0.73, 0.92) per standard deviation on immediate verbal recall, and a decreased hazard of 23% (HR 0.77, 95% CI (0.65, 0.08) per standard deviation on psychomotor speed. Participants aged ≥60 to <70 years had a significant decreased hazard of 11% (HR 0.89, 95% CI (0.80, 0.98) per standard deviation on immediate word recall. In participants aged <60 years, there was a decreased hazard of 14% (HR 0.86 95% CI: 0.76, 0.98), per standard deviation on psychomotor speed.
Conclusion: Better performance on neuropsychological tests increased pain tolerance on the cold pressor test. These exposure effects were present in all age groups.
Significance: This paper describes substantial associations between cognitive functioning and cold pressor tolerance in 4,623 participants. Reduced psychomotor speed and poor verbal recall gave greater odds for hand-withdrawal on the cold pressor task. The associations were stronger in older participants, indicating an interaction with age.
(© 2019 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.)
Databáze: MEDLINE
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