title: Cognitive function in older patients with postherpetic neuralgia.
abstract: OBJECTIVE
  Neuropathic pain has been shown to be accompanied by cognitive impairment, but the specific impact of postherpetic neuropathic pain on cognitive processes has not been explored. This study aims to evaluate the impact of pain on several domains of cognition in older patients with postherpetic neuralgia (PHN).
  
  
  METHODS
  This cross-sectional study (clinicaltrial.gov NCT 00989040) included 84 individuals after signature of informed consent.
  
  
  METHODS
  42 patients with PHN and 42 healthy volunteers. Of the 42 PHN patients, 21 received systemic treatment (antidepressants, anticonvulsants, opiates) and 21 had topical treatment with the 5% lidocaine medicated plaster. All participants performed a panel of four cognitive tests: reaction time, semantic memory, decision-making, and visual memory (Cantab, Cambridge).
  
  
  RESULTS
  Forty men and 44 women with a mean age of 72 ± 8 years participated. Each PHN patient was matched by age and gender with a healthy volunteer. Vigilance, decision-making, and semantic memory were significantly impaired (P < 0.05) in patients on systemic treatment, especially with antidepressants, while no significant changes were noted between the lidocaine plaster group and their matched controls of healthy volunteers.
  
  
  CONCLUSIONS
  This study shows the deleterious effect of systemic PHN treatment on several domains of cognition. Cognitive impairment associated with pain and antidepressants may be reversed by topical pain management. Topical treatment with 5% lidocaine medicated plaster is a valuable alternative for pain alleviation and maintains cognitive integrity in this vulnerable population.
authors.affiliation: CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Clermont-Ferrand, France; Inserm, CIC 501, UMR 766, Clermont-Ferrand, France; Clermont Université, Laboratoire de Pharmacologie, Faculté de médecine, Clermont-Ferrand, France.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Pickering
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.forename: Florentin
authors.initials: F
authors.lastname: Clère
authors.forename: Marc
authors.initials: M
authors.lastname: Sorel
authors.forename: Geraldine
authors.initials: G
authors.lastname: de Montgazon
authors.forename: Malou
authors.initials: M
authors.lastname: Navez
authors.forename: Pascale
authors.initials: P
authors.lastname: Picard
authors.forename: Delphine
authors.initials: D
authors.lastname: Roux
authors.forename: Véronique
authors.initials: V
authors.lastname: Morel
authors.forename: Rachida
authors.initials: R
authors.lastname: Salimani
authors.forename: Mireille
authors.initials: M
authors.lastname: Adda
authors.forename: Valérie
authors.initials: V
authors.lastname: Legout
authors.forename: Claude
authors.initials: C
authors.lastname: Dubray
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D003072:Cognition Disorders / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local
keywords: analgesics; cognitive impairment; neuropathic pain; postherpetic neuralgia; topical lidocaine