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Iezzi, Tony; Archibald, Yvonne; Barnett, Peter A.; Klinck, Ann; Duckworth, Melanie P.

doi:10.1023/a:1018791622441

Cited by 54 publications

(9 citation statements)

References 15 publications

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“…The extent to which our results suggest an inability to process monetary risk specifically, and in turn reflect a dysfunctional reward system in CBP, needs discussion. This is because reward perception and action may also be altered by an overall lack of or difference in emotional awareness during decisions [ 47 ] or by changes in attentional mechanisms [ 48 , 49 ]. Importantly, both of these alternatives might be due to our participants either having a history of chronic pain, which would affect the brain’s circuitry, and/or having a presence of pain while they are performing the task, which might change their scores.…”

Section: Discussionmentioning

confidence: 99%

“…This leads us to the second possibility mentioned above – that changes in attentional mechanisms or resources might be contributing to changes in connectivity and differences in behavior. Due to the overlap in the network regions involved in both chronic pain and reward, it is possible that the cognitive demand of the ongoing background pain may alter CBP patients’ ability to attend to the task (in this case, to attend to both losses and gains equally) [ 48 , 49 ], and in turn this may be reflected in our neuroimaging findings. Previous results have shown that CBP patients do not appear to have deficits in other types of tasks, including those measuring attention and short-term memory [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens

et al. 2014

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BackgroundThe nucleus accumbens (NAc) has a well established role in reward processing. Yet, there is growing evidence showing that NAc function, and its connections to other parts of the brain, is also critically involved in the emergence of chronic back pain (CBP). Pain patients are known to perform abnormally in reward-related tasks, which suggests an intriguing link between pain, NAc connectivity, and reward behavior. In the present study, we compared performance on a gambling task (indicating willingness to risk losing money) between healthy pain-free controls (CON) and individuals with CBP. We then measured modular connectivity of each participants’ NAc with resting state functional MRI to investigate how connectivity accounts for reward behavior in the presence and absence of pain.ResultsWe found gain sensitivity was significantly higher in CBP patients. These scores were significantly correlated to connectivity within the NAc module defined by CON subjects ( which had strong connections to the frontal cortex), but not within that defined by CBP patients ( which was more strongly connected to subcortical areas). An important part of our study was based on the precedence that a range of behaviors, from simple to complex, can be predicted from brain activity during rest. Thus, to corroborate our results we compared them closely to an independent study correlating the same connectivity metric to impulsive behaviors in healthy participants. We found that our CBP patients were highly similarin connectivity to this study’s highly-impulsive healthy subjects, strengthening the notion that there is an important link between the brain systems that support chronic pain and reward processing.ConclusionsOur results support previous findings that chronic back pain is accompanied by altered connectivity of the NAc. This lends itself to riskier behavior in these patients, a finding which establishes a potential cognitive consequence or co-morbidity of long-term pain and provides a behavioral link to growing research showing that chronic pain is related to abnormal changes in the dopaminergic system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens

et al. 2014

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“…Chronic pain has been associated with cognitive problems in the domains of memory, concentration, problem solving, abstract thinking, and cognitive efficiency 1-3 . Most evidence related to the adverse effect of pain on cognitive functioning is derived from chronic pain patients, including those with fibromyalgia, whiplash, arthritis and other chronic pain conditions 4-7 .…”

Section: Introductionmentioning

confidence: 99%

Associations between aspects of pain and cognitive performance and the contribution of depressive symptoms in mid-life women: A cross-sectional analysis

et al. 2015

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Objectives Pain has been associated with cognitive problems in pain patients. This study evaluated the extent to which experiences of pain are associated with cognitive performance in a community sample of mid-life women, and the contribution of depressive symptoms to this association. Study Design A cross-sectional analysis was used with data from the Study of Women’s Health Across the Nation (SWAN). Associations between aspects of pain and cognitive performance were evaluated using statistical models with and without depressive symptoms. Main Outcome Measures The cognitive performance score was a composite of three cognitive tests, the Digit Span Backward Test, the Symbol Digit Modalities Test and the East Boston Memory Test. Results Greater pain experiences that interfered with daily work were independently associated with poorer cognitive performance, [β (SE) −0.074 (0.021); p value <0.01] and this association was partially explained by depressive symptoms [β (SE) −0.061 (0.022); p value <0.01 after adjusting for depressive symptoms]. Additionally, an independent association between a greater composite pain score and poorer cognitive performance was identified without adjusting for depressive symptoms, [β (SE) −0.002 (0.0009); p value <0.05] but was no longer significant after adjusting for depressive symptoms. Conclusions Our results suggest that in mid-life women, greater pain is associated with poorer cognitive performance, and depressive symptoms play an important role in this association. Clinicians should be aware of these relationships when evaluating patients.

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“…First, patients with chronic pain complain of significant memory disturbances [1–5]. These complaints have been verified in standardised neurocognitive assessments of teenage, adult and elderly chronic pain patients across a range of chronic pain-causing conditions, and the severity of impairment is proportional to the degree of pain experienced at assessment [6–18]. Second, experimentally inducing pain in otherwise healthy volunteers interferes with memory function if the painful stimulus is applied during encoding and/or retrieval in long-term memory tasks [18–21].…”

Section: Introductionmentioning

confidence: 99%

Post-conditioning experience with acute or chronic inflammatory pain reduces contextual fear conditioning in the rat

Johnston

Maier

Rudy

et al. 2012

Behavioural Brain Research

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There is evidence that pain can impact cognitive function in people. The present study evaluated whether Pavlovian fear conditioning in rats would be reduced if conditioning were followed by persistent inflammatory pain induced by a subcutaneous injection of dilute formalin or complete Freund's adjuvant (CFA) on the dorsal lumbar surface of the back. Formalin-induced pain specifically impaired contextual fear conditioning but not auditory cue conditioning (Experiment 1A). Moreover, formalin pain only impaired contextual fear conditioning if it was initiated within 1 h of conditioning and did not have a significant effect if initiated 2, 8 or 32 h after (Experiments 1A and 1B). Experiment 2 showed that formalin pain initiated after a session of context pre-exposure reduced the ability of that pre-exposure to facilitate contextual fear when the rat was limited to a brief exposure to the context during conditioning. Similar impairments in context- but not CS-fear conditioning were also observed if the rats received an immediate post-conditioning injection with CFA (Experiment 3). Finally, we confirmed that formalin and CFA injected s.c. on the back induced pain-indicative behaviours, hyperalgesia and allodynia with a similar timecourse to intraplantar injections (Experiment 4). These results suggest that persistent pain impairs learning in a hippocampus-dependent task, and may disrupt processes that encode experiences into long-term memory.

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Untitled

Cited by 54 publications

References 15 publications

Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens

Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens

Associations between aspects of pain and cognitive performance and the contribution of depressive symptoms in mid-life women: A cross-sectional analysis

Post-conditioning experience with acute or chronic inflammatory pain reduces contextual fear conditioning in the rat

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