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Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia

(2015) PAIN PHYSICIAN. 18(3). p.E389-E401
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Organization
Abstract
Background: A growing body of research has demonstrated that impaired central pain modulation or central sensitization (CS) is a crucial mechanism for the development of persistent pain in chronic whiplash-associated disorders (WAD) and fibromyalgia (FM) patients. Furthermore, there is increasing evidence for cognitive dysfunctions among these patients. In addition, chronic WAD and FM patients often report problems with health-related quality of life (QoL). Yet, there is limited research concerning the interrelations between cognitive performance, indices of CS, and health-related QoL in these patients. Objectives: (1) Examining the presence of cognitive impairment, CS, and limitations on health-related QoL in patients with chronic WAD and FM compared to healthy controls. (2) Examining interrelations between performance-based cognitive functioning, CS, and self-reported health-related QoL in these 3 study groups. Study Design: A case-control study was conducted. Setting: The present study took place at the University Hospital Brussels, the University of Brussels, and the University of Antwerp. Methods: Fifty-nine patients (16 chronic WAD patients, 21 FM patients, and 22 pain-free volunteers) filled out the Short Form 36 item Health Survey (SF-36), a self-reported psychosocial questionnaire, to assess health-related QoL. Next, they were subjected to various pain measurements (pressure hyperalgesia, deep-tissue hyperalgesia, temporal summation [TS], and conditioned pain modulation [CPM]). Finally, participants completed a battery of performance-based cognitive tests (Stroop task, psychomotor vigilance task [PVT], and operation span task [OSPAN]). Results: Significant cognitive impairment, bottom-up sensitization, and decreased health-related QoL were demonstrated in patients with chronic WAD and FM compared to healthy controls (P < 0.017). CPM was comparable between the 3 groups. Cognitive performance was significantly related to central pain modulation (deep-tissue hyperalgesia, TS, CPM) as well as to self-reported health-related QoL (P < 0.05). Decreased cognitive performance was related to deficient central pain modulation in healthy controls. Further, significant correlations between decreased cognitive performance and reduced health-related QoL were revealed among all study groups. Additionally, FM patients showed correlations between cognitive impairment and increased health-related QoL. Remarkably, impaired selective attention and working memory were related to less TS, whereas impaired sustained attention was correlated with dysfunctional CPM in FM patients. Limitations: Based on the current cross-sectional study no firm conclusions can be drawn on the causality of the relations. Conclusion: In conclusion, this paper has demonstrated significant cognitive deficits, signs of CS, and reduced health-related QoL in chronic WAD and FM patients compared to healthy individuals. Significant relations between cognitive performance and CS as well as health-related QoL were demonstrated. These results provide preliminary evidence for the clinical importance of objectively measured cognitive deficits in patients with chronic WAD and FM.
Keywords
CHRONIC-FATIGUE-SYNDROME, PRESSURE PAIN THRESHOLDS, quality of life, cognition, temporal summation, conditioned pain modulation, central sensitization, whiplash, fibromyalgia, Chronic pain, LOW-BACK-PAIN, TEMPORAL SUMMATION, WIDESPREAD PAIN, PROGNOSTIC-FACTORS, SLEEP-DEPRIVATION, NECK PAIN, HYPERSENSITIVITY, INJURY

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MLA
Coppieters, Iris, et al. “Cognitive Performance Is Related to Central Sensitization and Health-Related Quality of Life in Patients with Chronic Whiplash-Associated Disorders and Fibromyalgia.” PAIN PHYSICIAN, vol. 18, no. 3, 2015, pp. E389–401.
APA
Coppieters, I., Ickmans, K., Cagnie, B., Nijs, J., De Pauw, R., Noten, S., & Meeus, M. (2015). Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia. PAIN PHYSICIAN, 18(3), E389–E401.
Chicago author-date
Coppieters, Iris, Kelly Ickmans, Barbara Cagnie, Jo Nijs, Robby De Pauw, Suzie Noten, and Mira Meeus. 2015. “Cognitive Performance Is Related to Central Sensitization and Health-Related Quality of Life in Patients with Chronic Whiplash-Associated Disorders and Fibromyalgia.” PAIN PHYSICIAN 18 (3): E389–401.
Chicago author-date (all authors)
Coppieters, Iris, Kelly Ickmans, Barbara Cagnie, Jo Nijs, Robby De Pauw, Suzie Noten, and Mira Meeus. 2015. “Cognitive Performance Is Related to Central Sensitization and Health-Related Quality of Life in Patients with Chronic Whiplash-Associated Disorders and Fibromyalgia.” PAIN PHYSICIAN 18 (3): E389–E401.
Vancouver
1.
Coppieters I, Ickmans K, Cagnie B, Nijs J, De Pauw R, Noten S, et al. Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia. PAIN PHYSICIAN. 2015;18(3):E389–401.
IEEE
[1]
I. Coppieters et al., “Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia,” PAIN PHYSICIAN, vol. 18, no. 3, pp. E389–E401, 2015.
@article{6906276,
  abstract     = {{Background: A growing body of research has demonstrated that impaired central pain modulation or central sensitization (CS) is a crucial mechanism for the development of persistent pain in chronic whiplash-associated disorders (WAD) and fibromyalgia (FM) patients. Furthermore, there is increasing evidence for cognitive dysfunctions among these patients. In addition, chronic WAD and FM patients often report problems with health-related quality of life (QoL). Yet, there is limited research concerning the interrelations between cognitive performance, indices of CS, and health-related QoL in these patients. 
Objectives: (1) Examining the presence of cognitive impairment, CS, and limitations on health-related QoL in patients with chronic WAD and FM compared to healthy controls. (2) Examining interrelations between performance-based cognitive functioning, CS, and self-reported health-related QoL in these 3 study groups. 
Study Design: A case-control study was conducted. 
Setting: The present study took place at the University Hospital Brussels, the University of Brussels, and the University of Antwerp. 
Methods: Fifty-nine patients (16 chronic WAD patients, 21 FM patients, and 22 pain-free volunteers) filled out the Short Form 36 item Health Survey (SF-36), a self-reported psychosocial questionnaire, to assess health-related QoL. Next, they were subjected to various pain measurements (pressure hyperalgesia, deep-tissue hyperalgesia, temporal summation [TS], and conditioned pain modulation [CPM]). Finally, participants completed a battery of performance-based cognitive tests (Stroop task, psychomotor vigilance task [PVT], and operation span task [OSPAN]). 
Results: Significant cognitive impairment, bottom-up sensitization, and decreased health-related QoL were demonstrated in patients with chronic WAD and FM compared to healthy controls (P < 0.017). CPM was comparable between the 3 groups. Cognitive performance was significantly related to central pain modulation (deep-tissue hyperalgesia, TS, CPM) as well as to self-reported health-related QoL (P < 0.05). Decreased cognitive performance was related to deficient central pain modulation in healthy controls. Further, significant correlations between decreased cognitive performance and reduced health-related QoL were revealed among all study groups. Additionally, FM patients showed correlations between cognitive impairment and increased health-related QoL. Remarkably, impaired selective attention and working memory were related to less TS, whereas impaired sustained attention was correlated with dysfunctional CPM in FM patients. 
Limitations: Based on the current cross-sectional study no firm conclusions can be drawn on the causality of the relations. 
Conclusion: In conclusion, this paper has demonstrated significant cognitive deficits, signs of CS, and reduced health-related QoL in chronic WAD and FM patients compared to healthy individuals. Significant relations between cognitive performance and CS as well as health-related QoL were demonstrated. These results provide preliminary evidence for the clinical importance of objectively measured cognitive deficits in patients with chronic WAD and FM.}},
  author       = {{Coppieters, Iris and Ickmans, Kelly and Cagnie, Barbara and Nijs, Jo and De Pauw, Robby and Noten, Suzie and Meeus, Mira}},
  issn         = {{1533-3159}},
  journal      = {{PAIN PHYSICIAN}},
  keywords     = {{CHRONIC-FATIGUE-SYNDROME,PRESSURE PAIN THRESHOLDS,quality of life,cognition,temporal summation,conditioned pain modulation,central sensitization,whiplash,fibromyalgia,Chronic pain,LOW-BACK-PAIN,TEMPORAL SUMMATION,WIDESPREAD PAIN,PROGNOSTIC-FACTORS,SLEEP-DEPRIVATION,NECK PAIN,HYPERSENSITIVITY,INJURY}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{E389--E401}},
  title        = {{Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia}},
  url          = {{http://www.painphysicianjournal.com/current/abstracts?article=MjMzMQ%3D%3D&journal=88}},
  volume       = {{18}},
  year         = {{2015}},
}

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