Cognitive impairment in patients with chronic back pain: possible approaches to the treatment
- 作者: Osipova D.V.1, Filatova E.G1,2, Latysheva N.V1,2
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隶属关系:
- Sechenov First Moscow State Medical University (Sechenov University)
- Alexander Vein Headache Clinic
- 期: 卷 26, 编号 13 (2019)
- 页面: 40-46
- 栏目: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/312381
- DOI: https://doi.org/10.18565/pharmateca.2019.13.40-46
- ID: 312381
如何引用文章
详细
Background. Patients with chronic back pain (CBP) often complain of memory loss, forgetfulness, inability to attention concentration, difficulties in planning, which leads to a significant decrease in the quality of life. Despite the frequent occurrence of the above symptoms in clinical practice, the prevalence and structure of cognitive impairment (CI) in CBP have not been studied. Objective. Evaluation of the prevalence and clinical structure of objective CI in patients with CBP, as well as factors important for its development. Methods. The study included 31 patients with CBP aged 18 to 59 years (22 women and 9 men). All patients underwent clinical neurological examination and filled out questionnaires including demographic and clinical characteristics, Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Function Assessment Scale (MoCA), Digital Symbol Substitution Test (DSST), and Rey Auditory Verbal Learning Test (RAVLT). Results. 63% of patients with CBP complained of memory loss. In an objective study of cognitive functions, the mean DSST score and RAVLT total recall test were also reduced compared to the standards. The MoCA score was at the lower limit of normal values and significantly differed from the average value for healthy people aged 40-50. In patients with CBP, a high prevalence of subjective and objective cognitive impairment was noted, a negative correlation for the DSST results with age, duration of the disease and the level of depression was found, and there was no correlation between the anxiety level and the indicators of cognitive function tests. Conclusion. Significant CI was revealed in patients with CBP. The likelihood of CI increases with prolonged course of CBP and with the development of comorbid depression. CBP remains an independent factor in the development of CI.
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作者简介
Diana Osipova
Sechenov First Moscow State Medical University (Sechenov University)
Email: kardi2004@gmail.com
Neurologist, PhD applicant
E. Filatova
Sechenov First Moscow State Medical University (Sechenov University); Alexander Vein Headache Clinic
N. Latysheva
Sechenov First Moscow State Medical University (Sechenov University); Alexander Vein Headache Clinic
参考
- Gureje O., Simon G.E., Von Korff M. A crossnational study of the course of persistent pain in primary care. Pain. 2001;92:195-200. doi: 10.1016/s0304-3959(00)00483-8.
- Лившиц Л.Я., Лобзин Ю.Я., Усин В.В., Никаноров Л.В. Опыт изучения распространенности хронических болевых синдромов. Российская науч.-практ. Конференция:«Организация медицинской помощи больным с болевыми синдромами». Тезисы докладов. Новосибирск, 1997. С. 34-5.
- Crombie I.K. Epidemiology of persistent pain. Proceedings of the 8-th World Congress on Pain: Progress in Pain Research and Management. Vol. 8. Eds T. S. Jensen et al. Seattle: IASP Press, 1997. P. 53-61.
- Павленко С.С. Состояние и проблемы эпидемиологических исследований болевых синдромов. Боль. 2006;4:2-7.
- Rubin D.I. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25:353-71. doi: 10.1016/j.ncL2007.01.004.
- Rowe L.J. Imaging of mechanical and degenerative syndromes of the lumbar spine. In: Clinical Anatomy and Management of Low Back Pain, Giles L.G.F. (ed.). Butterworth-Heinemann, Oxford, 1997. P. 275-313.
- Павленко С.С. Боли в нижней части спины (эпидемиология, клинико-диагностическая классификация, современные направления в диагностике, лечении и стандартизации медицинской помощи). Руководство. Новосибирск, 2007. 172 с.
- Bushnell M.C., Ceko M., Low L.A. Cognitive and emotional control of pain and its disruption оп chronic pain National Center for Complementary and Alternative Medicine, National Institutes of Health, 35 Convent Drive, Room 1C917, MSC 3711, Bethesda, Maryland20892-3711, USA.
- Villemure C., Bushnell M.C. Mood influences supraspinal pain processing separately from attention. J. Neurosci. 2009;29:705-15. doi: 10.1523/JNEUR0SCI.3822-08.2009.
- Glass J.M., Park D.C., Minear M., Crofford L.J. Memory beliefs and function in fibromyalgia patients. J. Psychosom Res. 2005;58(3):263-69. doi: 10.1016/j.jpsychores.2004.09.004.
- Schiltenwolf M., Akbar M., Hug A., et al. Evidence of specific cognitive deficits in patients with chronic low back pain under long-term substitution treatment of opioids. Pain Physician. 2014;17(1):9-20.
- Grace G.M., Nielson W.R., Hopkins M., Berg M.A. Concentration and memory deficits in patients with fibromyalgia syndrome. J. Clin Exp Neuropsychol. 1999;21(4):477-87. Doi:10.1076/ jcen.21.4.477.876.
- Munoz M., Esteve R. Reports of memory functioning by patients with chronic pain. Clin J. Pain. 2005;21(4):287-91.
- Apkarian A.V., Sosa Y., Sonty S., et al. Chronic back pain is assotiated with decreased prefrontal and thalamic gray matter density. J. Neuroscience. 2004;24:10410-15. Doi: 10.1523/ JNEURGSCI.2541-04.2004.
- Moriarty G., Ruane N., G'Gorman D., et al. Cognitive impairment in patients with chronic neuropathic or radicular pain: an interaction of pain and age. Front Behav Neurosci 2017;11:100. doi: 10.3389/fnbeh.2017.00100. PMID: 28659771.
- Landr0 N., Fors E., Vapenstad L., et al. The extent of neurocognitive dysfunction in a multidisciplinary pain centre population. Is there a relation between reported and tested neuropsychological functioning? Pain 2013; 154(7):972-77. doi: 10.1016/j.pain.2013.01.013. PMID: 23473784.
- Мелкумова К.А. Когнитивные расстройства у пациентов с хроническим болевым синдромом. Дисс. канд. мед. наук. М., 2009.
- Luoto S.,Taimela S.,Alaranta H., Hurri H. Psychomotorspeedinchroniclow-back pain patients and healthy controls: construct validity and clinical significance of the measure. Percept Mot Skills 1998;87:1283-96.
- Wechsler D. Adult Intelligence Scale - re-vised. New York: Psychological Corporation, 1981. P. 47.
- Geffen G., Moar K.J., G’Hanlon A.P., et al. Performance measures of 16- to 86-year-old males and females onthe auditory verbal learning test. Clin Neuropsychol. 1990;4(1):45-63. doi: 10.1080/13854049008401496. PMID: 29022439.
- Etherton J.L., Bianchini K.J., Heinly M.T., Greve K.W. Pain, malingering, and performance on the WAIS-III Processing Speed Index. J Clin Exp Neuropsychol. 2006;22:1212-37. doi: 10.1080/13803390500346595.
- Weiner D.K., Rudy T.E., Morrow L., et al. The relationship between pain, neuropsychological performance, and physical function in community-dwelling older adults with chronic low back pain. Pain Med. 2006;7:60-70. doi: 10.1111/j.1526-4637.2006.00091.x.
- Jorge L.L., Gerard C., Revel M. Evidences of memory dysfunction and maladaptive coping in chronic low back pain and rheumatoid arthritis patients: challenges for rehabilitation. Eur J Phys Rehabil Med. 2009;45:469-77.
- Schiltenwolf M., Akbar M., Neubauer E. The cognitive impact of chronic low back pain: Positive effect of multidisciplinary pain therapy. Scand J Pain. 2017. PMID: 28993113.
- Lam R., Kennedy S., Mclntyre R., et al. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry, 2014;59(12):649 54. doi: 10.1177/070674371405901206. PMID: 25702365
- McIntyre R., Soczynska J., Woldeyohannes H. et al. The impact of cognitive impairment on perceived workforce performance: results from the International Mood Disorders Collaborative Project. Compr Psychiatry. 2015;56:279-82. doi: 10.1016/j.comppsych.2014.08.051. PMID: 25439523.
- Santangelo G., Russo A., Trojano L., et al. Cognitive dysfunctions and psychological symptoms in migraine without aura: a cross-sectional study. J. Headache Pain. 2016;17(1):76. Doi: 10.1186/ s10194-016-0667-0. PMID: 27568039.
- Tesio V., Torta D., Colonna F., et al. Are fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence. Arthritis Care Res (Hoboken). 2015;67(1):143-50. doi: 10.1002/acr.22403. PMID: 25047247.
- Ferreira K., Oliver G., Thomaz D., et al. Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use. Arq Neuropsiquiatr. 2016;74(5):361-66. doi: 10.1590/0004-282X20160071. PMID: 27191230.
- Латышева Н.В., Филатова Е.Г., Осипова Д.В. Депрессия - не единственная причина когнитивных нарушений у пациентов с хронической мигренью. Нервно-мышечные болезни. 2018;4:35-2.
- Apkarian A.V., Sosa Y., Sonty S., et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J. Neurosci. 2004;24:10410-15. Doi: 10.1523/ JNEUROSCI.2541-04.2004.
- Grachev I.D., Fredrickson B.E., Apkarian A.V. Abnormaibrainchemi s - try in chronic back pain: an in vivo proton magnetic resonance spectros -copy study. Pain. 2000;89:7-18. Doi: 10.1016/ s0304-3959(00)00340-7.
- Conradi H., Ormei J., de Jonge P. Presence of individuai (residuai) symptoms during depressive episodes and periods of remission: a 3-year prospective study. PsychoiMed 2011;41(6):1165-74. doi: 10.1017/S0033291710001911. PMID: 20932356.
- Nekovarova T., Yamamotova A., Vaies K., et ai. Common mechanisms of pain and depression: are antidepressants aiso anaigesics? Frontiers in Behaviorai Neurosci 2014;8:99.
- Santareiii L., Saxe M., Gross C., et ai. Requirement of hippocampai neurogenesis for the behavioral effects of antidepressants. Science. 2003;301(5634): 805-9. Doi: 10.1126/ science.1083328. PMID: 12907793.
- Shiiyansky C., Wiiiiams L., Gyurak A., et ai. Effect of antidepressant treatment on cognitive impairments associated with depression: a randomised iongitudinai study Lancet Psychiatry 2016;3(5):425-35. doi: 10.1016/s2215-0366(16)00012-2. PMID: 26995298.
- Stahi S. Modes and nodes expiainthe mechanism of action of vortioxetine, a muitimodai agent (MMA): modifying serotonin's downstream effects on giutamate and GABA (gamma amino butyric acid) reiease. CNS Spectrums. 2015:20(4);331-36. Doi: 10.1017/ S1092852915000334. PMID: 26062900
- Pehrson A., Cremers T., Betry С., et ai. Lu AA21004, a novei muitimodai antidepressant, produces regionaiiy seiective increases of muitipie neurotransmitters - a rat microdiaiysis and eiectrophysioiogystudy. Eur Neuropsychopharmacoi, 2013;23(2):133-45. Doi: 10.1016/j. euroneuro.2012.04.006. PMID: 22612991.
- Sanchez C., Asin K., Artigas F Vortioxetine, a novei antidepressant with muitimodai activity: review of preciinicai and ciinicai data. Pharmacoi Ther. 2015; 145:43-57. doi: 10.1016/j.pharmthera. 2014.07.001. PMID: 25016186.
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