Cognitive impairment in patients with chronic back pain: possible approaches to the treatment
D.V. Osipova (1), E.G. Filatova (1, 2), N.V. Latysheva (1, 2)
1) Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2) Alexander Vein Headache Clinic, Moscow, Russia
Background. Patients with chronic back pain (CBP) often complain of memory loss, forgetfulness, inability to attention concentration, difficulties in planning, which leads to a significant decrease in the quality of life. Despite the frequent occurrence of the above symptoms in clinical practice, the prevalence and structure of cognitive impairment (CI) in CBP have not been studied.
Objective. Evaluation of the prevalence and clinical structure of objective CI in patients with CBP, as well as factors important for its development.
Methods. The study included 31 patients with CBP aged 18 to 59 years (22 women and 9 men). All patients underwent clinical neurological examination and filled out questionnaires including demographic and clinical characteristics, Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Function Assessment Scale (MoCA), Digital Symbol Substitution Test (DSST), and Rey Auditory Verbal Learning Test (RAVLT).
Results. 63% of patients with CBP complained of memory loss. In an objective study of cognitive functions, the mean DSST score and RAVLT total recall test were also reduced compared to the standards. The MoCA score was at the lower limit of normal values and significantly differed from the average value for healthy people aged 40-50. In patients with CBP, a high prevalence of subjective and objective cognitive impairment was noted, a negative correlation for the DSST results with age, duration of the disease and the level of depression was found, and there was no correlation between the anxiety level and the indicators of cognitive function tests.
Conclusion. Significant CI was revealed in patients with CBP. The likelihood of CI increases with prolonged course of CBP and with the development of comorbid depression. CBP remains an independent factor in the development of CI.
Keywords: chronic back pain, chronic pain, cognitive impairment, depression, memory, attention
About the Autors
Corresponding author: Diana V. Osipova, Neurologist, PhD applicant, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; e-mail: firstname.lastname@example.org; ORCID: https://orcid.org/0000-0001-6213-5283
Address: 8, build. 2, Trubetskaya Street, Moscow 119991, Russian Federation