• Curr Pain Headache Rep · Apr 2003

    Review

    Cognitive impairment in patients with chronic pain: the significance of stress.

    • Robert P Hart, James B Wade, and Michael F Martelli.
    • Department of Psychiatry, VCU Health System, P.O. Box 980268, Richmond, VA 23298-0268, USA.
    • Curr Pain Headache Rep. 2003 Apr 1; 7 (2): 116-26.

    AbstractThis review article examines the role of emotional distress and other aspects of suffering in the cognitive impairment that often is apparent in patients with chronic pain. Research suggests that pain-related negative emotions and stress potentially impact cognitive functioning independent of the effects of pain intensity. The anterior cingulate cortex is likely an integral component of the neural system that mediates the impact of pain-related distress on cognitive functions, such as the allocation of attentional resources. A maladaptive physiologic stress response is another plausible cause of cognitive impairment in patients with chronic pain, but a direct role for dysregulation of the hypothalamic-pituitary-adrenocortical axis has not been systematically investigated.

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