Impaired psychomotor ability and attention in patients with persistent pain: a cross-sectional comparative study

Abstract

Helena Gunnarsson,1,2 Birgitta Grahn,3–5 Jens Agerström1 1Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Vaxjo, 2Hälsoringen, Neron HSU AB, Osby, 3Department of Clinical Sciences Lund-Orthopedics, Lund University, 4Epidemiology and Register Centre South, Region Skåne, Lund, 5Department of Research and Development, Region Kronoberg, Vaxjo, Sweden Background and aims: Patients with pain have shown cognitive impairment across various domains. Although the pain qualities vary among patients, research has overlooked how cognitive performance is affected by the duration and persistence of pain. The current study sought to fill this gap by examining how qualitatively different pain states relate to the following cognitive functions: sustained attention, cognitive control, and psychomotor ability. Patients and methods: Patients with musculoskeletal pain in primary care were divided into three pain groups: acute pain (duration <3 months), regularly recurrent pain (duration >3 months), and persistent pain (duration >3 months). These groups were then compared with healthy controls. The MapCog Spectra Test, the Color Word Test, and the Grooved Pegboard Test were used to measure sustained attention, cognitive control, and psychomotor ability, respectively. Results: Patients with persistent pain showed significantly worse sustained attention and psychomotor ability compared with healthy controls. The acute pain group showed a significant decrease in psychomotor ability, and the regularly recurrent pain group showed a significant decrease in sustained attention. These results remained unchanged when age, education, and medication were taken into account. Conclusion: Persistent musculoskeletal pain seems to impair performance on a wider range of cognitive tasks than acute or regularly recurrent pain, using pain-free individuals as a benchmark. However, there is some evidence of impairment in psychomotor ability among patients with acute pain and some impairment in sustained attention among patients with regularly recurrent pain. Implications: Caregivers may need to adjust communication methods when delivering information to cognitively impaired patients. Keywords: persistent pain, cognitive impairment, musculoskeletal pain, psychomotor ability, attention, cognitive control

Keywords

• Persistent pain
• cognitive impairment
• musculoskeletal pain
• psychomotor ability
• attention
• cognitive control.