title: Do people with chronic pain have impaired executive function? A meta-analytical review.
abstract: A widely held belief within the clinical community is that chronic pain is associated with cognitive impairment, despite the absence of a definitive systematic review or meta-analysis on the topic. The current systematic review and meta-analysis aimed to establish the current evidence concerning the difference in executive function between people with chronic pain and healthy controls. Six databases were searched for citations related to executive function and chronic pain from inception to June 24, 2013. Two reviewers independently assessed studies for eligibility and extracted relevant data according to the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty five studies were included in the review and twenty two studies in the meta-analysis. A small to moderate impairment in executive function performance was found in people with chronic pain across cognitive components, although all studies had a high risk of bias. The current evidence suggests impairment of executive function in people with chronic pain, however, important caveats exist. First, executive function involves many cognitive components and there is no standard test for it. Second, moderators of executive function, such as medication and sleep, were seldom controlled for in studies of executive function performance.
authors.affiliation: Sansom Institute for Health Research, Adelaide & PainAdelaide, University of South Australia, Adelaide, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Berryman
authors.affiliation: Sansom Institute for Health Research, Adelaide & PainAdelaide, University of South Australia, Adelaide, Australia; Neuroscience Research Australia, Sydney, Australia.
authors.forename: Tasha R
authors.initials: TR
authors.lastname: Stanton
authors.affiliation: Sansom Institute for Health Research, Adelaide & PainAdelaide, University of South Australia, Adelaide, Australia.
authors.forename: K Jane
authors.initials: KJ
authors.lastname: Bowering
authors.affiliation: Sansom Institute for Health Research, Adelaide & PainAdelaide, University of South Australia, Adelaide, Australia; School of Biomedical Sciences, King's College, London, United Kingdom.
authors.forename: Abby
authors.initials: A
authors.lastname: Tabor
authors.affiliation: Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: McFarlane
authors.affiliation: Sansom Institute for Health Research, Adelaide & PainAdelaide, University of South Australia, Adelaide, Australia; Neuroscience Research Australia, Sydney, Australia. Electronic address: lorimer.moseley@unisa.edu.au.
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
mesh_terms: D059350:Chronic Pain / Q000150:complications / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology*; D006801:Humans
keywords: Chronic pain; Executive function; Meta-analysis; Stroop; Systematic review