title: Response inhibition, set shifting, and complex executive function in patients with chronic lower back pain.
abstract: OBJECTIVE
  The aim of our study was to evaluate how response inhibition, set shifting, and complex executive function (represented by risky decision-making) are altered in chronic lower back pain patients.
  
  
  METHODS
  A total of 29 patients with chronic lower back pain (CLBP >6 months) aged 49-69 years and 30 healthy volunteers matched for age, gender, and education were enrolled in a case-control study. The study was conducted in the Departments of Neurology and Neurosurgery of Panevėžys Regional Hospital, Lithuania. Pain was evaluated by the visual analog scale, Pakula Pain Questionnaire (Lithuanian analog of McGill Pain Questionnaire), and Fibromyalgia Tender Points Examination. A battery of neuropsychological tests used included Stroop Test Victoria version, Trail Making Test parts A and B, and Game of Dice Task (GDT).
  
  
  RESULTS
  CLBP patients did not score significantly worse in any examined neuropsychological tests. Response Inhibition correlated inversely with number of tender points in CLBP patients. GDT performance showed no significant difference in net score (number of safe minus risky decisions). Unexpectedly, both groups favored risky decisions.
  
  
  CONCLUSIONS
  We found no statistically significant difference in response inhibition, set shifting, or complex executive function between CLBP patients and healthy older adults. Moreover, a risky decision-making pattern found in the Lithuanian population may underscore the importance of cultural context when examining complex executive function. However, further studies are needed to prove this point.
authors.affiliation: Department of Neurology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania; Clinics of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. Electronic address: rytis.masiliunas@santa.lt.
authors.forename: Rytis
authors.initials: R
authors.lastname: Masiliūnas
authors.affiliation: Klinik Kirchheim, Kreiskliniken Esslingen, Kirchheim unter Teck, Germany.
authors.forename: Dalia
authors.initials: D
authors.lastname: Vitkutė
authors.affiliation: Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Edgaras
authors.initials: E
authors.lastname: Stankevičius
authors.affiliation: Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Vaidas
authors.initials: V
authors.lastname: Matijošaitis
authors.affiliation: Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Kęstutis
authors.initials: K
authors.lastname: Petrikonis
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D059350:Chronic Pain / Q000523:psychology*; D003071:Cognition; D003657:Decision Making; D056344:Executive Function; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010147:Pain Measurement; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Chronic lower back pain; Decision-making; Executive function; Stroop test; Trail Making Test