复杂局部疼痛综合征患者的认知功能：在一个选定的患者样本中没有发现明显的损伤

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-06-02 DOI:10.1002/ejp.70046

Corinne van den Berg, Esther van den Berg, Frank J. P. M. Huygen, Jitske Tiemensma

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引用次数: 0

摘要

鉴于慢性疼痛对认知的影响，CRPS可能会影响特定的认知功能。然而，认知功能在CRPS中很少被评估，以前的研究只检查了有限的领域。因此，目前尚不清楚哪些认知功能受到影响，以及损害是否与crps特异性有关。本研究综合评价CRPS患者的认知能力，并将其与腕管综合征（carpal tunnel syndrome， CTS）进行比较，以确定CRPS患者是否存在认知功能障碍。方法对所有患者进行标准化的认知评估，包括10项测试，评估记忆、注意力、执行功能、社会认知和工作效度。检验了标准化z分数和表现不佳患者的比例（< - 1.5 SD，来自年龄、性别和教育程度调整后的规范数据）。比较两组患者之间的差异及预期人群比例。结果64例患者（n = 39 CRPS和n = 25 CTS），平均年龄52.5岁（范围20-81岁）。与CTS患者相比，CRPS患者在就诊前24 h和就诊期间的疼痛评分显著高于CTS患者（p < 0.001）。两组之间的所有认知测试结果相似。两组的z -得分均与总体标准相当或更好。此外，z评分低于- 1.5 SD的患者比例与预期相似或更好。结论我们的结果一致显示两组患者均无认知障碍。两组在所有测试中都达到或超过了总体标准。然而，尽管我们得到了明确的结果，我们仍应注意影响认知的因素，如抑郁、焦虑和压力。意义声明本研究探讨了复杂局部疼痛综合征（CRPS）中未被充分研究的认知功能障碍。认知问题通常由CRPS患者报告，可增加日常生活和生活质量（QoL）的负担，但很少进行评估。通过比较CRPS与CTS，本研究探讨认知障碍是否为CRPS所特有。识别这些问题可能会导致针对疼痛和认知挑战的靶向治疗，最终改善患者的预后和生活质量。

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Cognitive Function in Patients With Complex Regional Pain Syndrome: No Clear Impairment Found in a Select Patient Sample

Background

Given the impact of chronic pain on cognition, CRPS may affect specific cognitive functions. However, cognitive functioning is rarely assessed in CRPS, and previous studies have examined only limited domains. As a result, it remains unclear which cognitive functions are affected and whether impairments are CRPS-specific. This study comprehensively evaluates cognition in CRPS and compares it to carpal tunnel syndrome (CTS) to determine whether cognitive dysfunction is specific to CRPS.

Methods

All patients underwent a standardised cognitive assessment consisting of ten tests, evaluating the domains of memory, concentration, executive functioning, social cognition and performance validity. Standardised z-scores and proportion of low-performing patients (< −1.5 SD from age-, sex- and education adjusted normative data) were examined. Both patient groups were compared with each other and the expected population proportion.

Results

Sixty-four patients (n = 39 CRPS and n = 25 CTS) with a mean age of 52.5 (range 20–81) were included. Compared with patients with CTS, patients with CRPS had significantly higher pain scores 24 h before and during the visit (p < 0.001). All cognitive test results were similar between the two groups. Z-scores of both groups were comparable or better than the population norm. Furthermore, proportions of patients with Z-scores below −1.5 SD were similar or better than expected.

Conclusions

Our results consistently showed no cognitive impairment in either patient group. Both groups met or exceeded population norms on all tests. However, despite our clear results, attention should be paid to factors affecting cognition, like depression, anxiety and stress.

Significance Statement

This study explores the underexamined cognitive dysfunction in Complex Regional Pain Syndrome (CRPS). Cognitive issues, often reported by CRPS patients, can add to the burden on daily life and quality of life (QoL) but are rarely assessed. By comparing CRPS with CTS, this research examines whether cognitive impairments are specific to CRPS. Identifying these issues may lead to targeted therapies addressing both pain and cognitive challenges, ultimately improving patient outcomes and QoL.

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.