Reciprocal influences of physical function and cognitive inhibition in chronic pain states

Abstract

Chronic pain is associated with deficits in cognitive function and decreased physical functioning, both significantly impacting daily life of chronic pain patients. Evidence for cognitive inhibitory deficits in chronic pain patients is mixed; research in this area is complicated by the heterogeneity of chronic pain disorders and the variety of tasks used to measure cognitive inhibition. Although the exact mechanisms underlying cognitive deficits in chronic pain are currently not known, processing of pain and cognition occurs in overlapping brain areas and significant changes in grey matter density and functional changes in these areas have been observed in chronic pain patients. Because physical fitness has been associated with neuroprotective effects and improved cognition in healthy adults, it has been suggested that improving physical fitness in chronic pain patients might benefit cognitive inhibitory ability. However, some evidence is available that cognitive inhibitory capacity mediates the relationship between pain and physical function, in which case development of clinical interventions should focus on improving cognitive inhibitory ability. Future research on the mechanisms underlying cognitive inhibitory deficits and decreased physical function in chronic pain patients should aim to clarify the direction of the relationship between these factors.