The association between chronic pain and deficits in attention: Is it mediated by disturbed sleep?

IF 1.3 Q4 CLINICAL NEUROLOGY
Giulia Zerbini, Cindy Strömel-Scheder, Anna Karmann, Philip Lang, Miriam Kunz, Stefan Lautenbacher
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引用次数: 0

Abstract

Objective: Persons with chronic pain suffer from additional symptoms and deficits that are directly or indirectly related to their condition. Attentional deficits are a common problem in these individuals. The same is true for sleep disturbances. It is well-known that night sleep affects attention the next day. Therefore, sleep disturbances might be responsible for the association between chronic pain and deficits in attention.

Methods: We studied the gaze behaviour (absolute and relative fixation times, i.e., attentional biases) in patients with chronic musculoskeletal pain (N = 20) and pain-free individuals (N = 28). For that purpose, we used an eye-tracker to monitor gaze behaviour during the presentation of affective stimuli, that is, pictures of faces displaying joy, anger, pain, and neutral expressions. In addition, we assessed subjective/wellbeing parameters, as well as objective sleep parameters with a portable polysomnography (PSG) device during two nights at home, with the aim of testing the mediating role of sleep for the relationship between chronic pain and alterations of attention.

Results: Patients with chronic pain exhibited overall shorter fixation times (on average ∼160 ms shorter fixation times). With respect to the attentional biases, all participants looked longer at the affective faces compared to the neutral ones, independent of group or type of affective stimulus. Several subjective sleep/wellbeing parameters, together with two PSG parameters (sleep efficiency and duration of awakenings), were significantly worse in patients with chronic pain. Despite this, only subjective sleep quality and sleep efficiency mediated the association of chronic pain and attentional processes.

Conclusions: Our findings confirm previous studies showing attentional deficits and sleep disturbances in patients with chronic pain. However, our results only partially support the hypothesis that the relationship between chronic pain and altered attentional processes is due to disturbed sleep. Other mechanisms might be involved, highlighting the need for further studies.

慢性疼痛和注意力缺陷之间的关系:是否由睡眠紊乱介导?
目的:患有慢性疼痛的人遭受直接或间接与其病情相关的其他症状和缺陷。注意力缺陷是这些人的共同问题。睡眠障碍也是如此。众所周知,晚上的睡眠会影响第二天的注意力。因此,睡眠障碍可能是慢性疼痛和注意力缺陷之间联系的原因。方法:我们研究了慢性肌肉骨骼疼痛患者(N = 20)和无痛患者(N = 28)的凝视行为(绝对注视时间和相对注视时间,即注意偏差)。为此,我们使用眼动仪来监测情感刺激呈现期间的凝视行为,即显示喜悦,愤怒,痛苦和中性表情的面部图片。此外,我们在家中使用便携式多导睡眠仪(PSG)评估了主观/健康参数以及客观睡眠参数,目的是测试睡眠在慢性疼痛和注意力改变之间的关系中的中介作用。结果:慢性疼痛患者的整体固定时间较短(平均固定时间缩短~ 160 ms)。在注意偏差方面,所有参与者都比中性面孔看得更久,这与群体或类型的情感刺激无关。慢性疼痛患者的几个主观睡眠/健康参数,以及两个PSG参数(睡眠效率和觉醒持续时间)明显更差。尽管如此,只有主观睡眠质量和睡眠效率介导了慢性疼痛和注意力过程的关联。结论:我们的发现证实了先前的研究表明慢性疼痛患者存在注意力缺陷和睡眠障碍。然而,我们的结果只是部分支持慢性疼痛和注意力过程改变之间的关系是由于睡眠紊乱的假设。可能涉及其他机制,因此需要进一步研究。
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来源期刊
British Journal of Pain
British Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.20
自引率
11.10%
发文量
42
期刊介绍: British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.
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