title: Neurodegenerative properties of chronic pain: cognitive decline in patients with chronic pancreatitis.
abstract: Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance), use of opioids, and premorbid alcohol abuse. The cognitive profiles of 16 patients with severe pain due to chronic pancreatitis were determined using an extensive neuropsychological test battery. Data from three cognitive domains (psychomotor performance, memory, executive functions) were compared to data from healthy controls matched for age, gender and education. Multivariate multilevel analysis of the data showed decreased test scores in patients with chronic pancreatitis pain in different cognitive domains. Psychomotor performance and executive functions showed the most prominent decline. Interestingly, pain duration appeared to be the strongest predictor for observed cognitive decline. Depressive symptoms, sleep disturbance, opioid use and history of alcohol abuse provided additional explanations for the observed cognitive decline in some of the tests, but to a lesser extent than pain duration. The negative effect of pain duration on cognitive performance is compatible with the theory of neurodegenerative properties of chronic pain. Therefore, early and effective therapeutic interventions might reduce or prevent decline in cognitive performance, thereby improving outcomes and quality of life in these patients.
authors.affiliation: Donders Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Marijtje L A
authors.initials: ML
authors.lastname: Jongsma
authors.forename: Simone A E
authors.initials: SA
authors.lastname: Postma
authors.forename: Pierre
authors.initials: P
authors.lastname: Souren
authors.forename: Martijn
authors.initials: M
authors.lastname: Arns
authors.forename: Evian
authors.initials: E
authors.lastname: Gordon
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
authors.forename: Oliver
authors.initials: O
authors.lastname: Wilder-Smith
authors.forename: Clementina M
authors.initials: CM
authors.lastname: van Rijn
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D059350:Chronic Pain / Q000150:complications* / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D003710:Demography; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D015999:Multivariate Analysis; D009410:Nerve Degeneration / Q000150:complications* / Q000503:physiopathology; D009483:Neuropsychological Tests; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000503:physiopathology; D011597:Psychomotor Performance