• John A Sturgeon, Meghan M Tieu, Laura E Jastrzab, Rebecca McCue, Vanisha Gandhi, and Sean C Mackey.
• Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Systems Neuroscience and Pain Laboratory, Stanford University, Palo Alto, California, USA.
• Pain Med. 2015 Jul 1; 16 (7): 1301-10.

ObjectiveA bidirectional relationship between working memory (WM) and acute pain has long been assumed, but equivocal evidence exists regarding this relationship. This study characterized the relationship between WM and acute pain processing in healthy individuals using an adapted Sternberg WM task.DesignParticipants completed a Sternberg task while receiving noxious thermal stimulation. Participants received a pseudorandom presentation of four different temperatures (baseline temperatures and individually determined low-, medium-, and high-temperature stimuli) and four levels of Sternberg task difficulty (0-, 3-, 6-, and 9-letter strings).SubjectsTwenty-eight healthy participants were recruited from Stanford University and the surrounding community to complete this study.ResultsA nonlinear interaction between intensity of thermal stimulation and difficulty of the Sternberg task was noted. Increased cognitive load from the Sternberg task resulted in increased perception of pain in low-intensity thermal stimulation but suppressed pain perception in high-intensity thermal stimulation. Thermal stimulation had no significant effect on participants' response time or accuracy on the Sternberg task regardless of intensity level.ConclusionsPain perception appears to decrease as a function of WM load only for sufficiently noxious stimuli. However, increasing noxious stimuli did not affect cognitive performance. These complex relationships may reflect a shared cognitive space that can become "overloaded" with input of multiple stimuli of sufficient intensity.Wiley Periodicals, Inc.

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