The Effects of Cold Pressor-Induced Pain on PASAT Performance

Abstract

Although clinicians have frequently observed that patients with chronic pain experience cognitive deficits related to memory and concentration, research on these deficits is equivocal, with some studies showing significant impairment and others suggesting minimal deficits. As such, the present study sought to examine the relationship between laboratory-induced pain and performance on the Paced Auditory Serial Addition Test (PASAT) using a mixed factorial design. Seventy-two nonclinical volunteers were randomly assigned to a pain group, who took the PASAT while experiencing cold pressor-induced pain, or a control group, who took the PASAT while experiencing painless room-temperature water immersion. To account for practice effects, all participants were administered 1 practice trial and 3 standard trials of the PASAT, with the final trial administered in cold pressor-induced pain or painless water immersion. The results revealed a significant interaction between condition and PASAT performance, F(1, 64) = 23.63, p < .001, partial η(2) = .27. The control group increased performance by 6 items while the pain group showed no such improvement. The results suggest that because the pain group did not demonstrate the same practice effects relative to the control group, their performance was impaired by cold pressor-induced pain. However, the impairment was relatively mild (about 0.5 standard deviation) and did not occur in all participants.

Pain Catastrophizing Mediates and Moderates the Link Between Acute Pain and Working Memory

“…Hypothesis 1 (pain group would report greater state-level catastrophizing and demonstrate worse verbal and non-verbal WM) was partially supported, such that the pain group reported greater state-level catastrophizing than the control group, which aligns with previous research [12,24,68]. The pain and control groups performed similarly on WM tasks, which conflicts with much of the experimental literature [9,34,53,73]. Although these non-significant total effects (group → WM) are initially surprising, they are better understood when considered alongside the significant mediation.…”

Central Sympathetic Nervous System Effects on Cognitive-Motor Performance

“…Put in a nutshell, our results thus confirm the idea that any deviation from optimal central SNS tone, relative to task requirements, may lead to a decrement in performance and that mental arithmetic (often employed as part of human stress induction protocols) might be particularly susceptible to interference by altered SNS activity. In view of this, previous reports of impaired PASAT performance during stress protocols that also cause strong changes in autonomic arousal and central SNS activity, such as the cold pressor task (Tapscott & Etherton, 2015), might be explained not only in terms of distraction and/or (coldinduced) pain but possibly also as a result of impinging effects on cognitive performance. At the same time, the present findings also point to the underlying adaptive nature of adrenergic modulation of cognition during the human stress response, which likely serves to selectively benefit certain perceptional and attentional processes (associated with fast, e.g., evasive, behavioral responses critical to survival) at the cost of others.…”

“…Put in a nutshell, our results thus confirm the idea that any deviation from optimal central SNS tone, relative to task requirements, may lead to a decrement in performance and that mental arithmetic (often employed as part of human stress induction protocols) might be particularly susceptible to interference by altered SNS activity. In view of this, previous reports of impaired PASAT performance during stress protocols that also cause strong changes in autonomic arousal and central SNS activity, such as the cold pressor task (Tapscott & Etherton, 2015), might be explained not only in terms of distraction and/or (cold-induced) pain but possibly also as a result of impinging effects on cognitive performance.…”