Background & Aims

Individuals with chronic pain frequently experience deficits or declines in cognitive functions [1, 2, 3]. Although pain itself can be an important contributor to these deficits, it is also reasonable to assume that individuals’ cognitive abilities could affect pain processing by influencing its top-down modulation.
It is hypothesized that efficient executive control can indicate better pain inhibitory capacity and, therefore, a reduction in pain sensitivity. Previous studies [4, 5] have found that better cognitive inhibition was associated with lower sensitivity to pain and higher pain tolerance.
Few studies have directly explored the relationship between cognitive inhibition and pain perception. Consequently, in this pilot validation study cognitive inhibitory functions and their role in pain inhibition are intended to be investigated by using a Stop-Signal Task in combination with assessment of pain sensitivity with cuff pressure algometry.

Methods

Ten (10) healthy volunteers (30.6±6.6) participated in the validation of the protocol. Cognitive inhibitory functions were assessed using a stop-signal task where the psychometric function of the stop-signal delay was estimated using the Psi Method [6] from this, the stop-signal reaction time (SSRT) and the SSRT probability quantile range (75% – 25%) (qSSRT) were calculated.
Pain sensitivity was assessed using pain detection (PDT) and tolerance thresholds (PTT), temporal summation (TS), and conditioned pain modulation (CPM) [7], and a novel protocol that determined three psychometric functions with the Psi Method to pressure stimuli; 1) 0.75s unconditioned pressure stimuli, 2) 3.0s unconditioned pressure stimuli, and 3) 3.0s conditioned pressure stimuli. The 3.0s pressure stimuli was conditioned using a cold pressure test at 10.0 degree Celsius.
Subjects were divided into low and high inhibitory cognitive control based on median of the stop-signal reaction time (SSRT).

Results

Conditioned pain index (CPI) was calculated as the ratio between the conditioned and unconditioned 3.0s pressure stimuli, the strength duration index (SDI) was calculated as the ratio between the unconditioned 0.75s and 3.0s pressure stimuli. Pearsons’ correlations showed significant results between SSRT and CPI (p=0.047; r=0.713); qSSRT and CPI (p=0.028; r=0.763); qSSRT and SDI (p=0.050, r=0.707). The increase in PPT due to CPM was higher in the high (mean=117.2, SD=17.6) than in the low (mean=105.1, SD = 7.6) inhibitory cognitive control group.

Conclusions

The results of this pilot validation study indicates that there are relevant results to be obtained in the full study. The finding of correlations between the stop-signal reaction time (SSRT), quantile of the psychometric function (qSSRT) and the conditional pain modulation indicates that inhibitory cognitive control might influence the descending pain inhibitory control. Furthermore the correlation with qSSRT indicates that the variance in the cognitive inhibitory control may also play an important role in top-down modulation of pain.

References

[1] Khera, T., & Rangasamy, V. (2021). Cognition and pain: a review. Frontiers in psychology, 12, 1819.
[2] Higgins, D. M., Martin, A. M., Baker, D. G., Vasterling, J. J., & Risbrough, V. (2018). The relationship between chronic pain and neurocognitive function: a systematic review. The Clinical journal of pain, 34(3), 262.
[3] Berryman, C., Stanton, T. R., Bowering, K. J., Tabor, A., McFarlane, A., & Moseley, G. L. (2014). Do people with chronic pain have impaired executive function? A meta-analytical review. Clinical psychology review, 34(7), 563-579.
[4] Bjeki?, J., Živanovi?, M., Puri?, D., Oosterman, J. M., & Filipovi?, S. R. (2018). Pain and executive functions: a unique relationship between Stroop task and experimentally induced pain. Psychological research, 82, 580-589.
[5] Oosterman, J. M., Dijkerman, H. C., Kessels, R. P., & Scherder, E. J. (2010). A unique association between cognitive inhibition and pain sensitivity in healthy participants. European Journal of Pain, 14(10), 1046-1050.
[6] Kontsevich, L. L., & Tyler, C. W. (1999). Bayesian adaptive estimation of psychometric slope and threshold. Vision research, 39(16), 2729-2737.
[7] Vaegter, H. B., Andersen, T. E., Harvold, M., Andersen, P. G., & Graven-Nielsen, T. (2018). Increased pain sensitivity in accident-related chronic pain patients with comorbid posttraumatic stress. The Clinical journal of pain, 34(4), 313-321.

Presenting Author

Laura Petrini

Poster Authors

Laura Petrini

PhD

Aalborg University

Lead Author

E-mail

Kristian Hennings

Lead Author

E-mail

Giulia Erica Aliotta

Aalborg University

Lead Author

E-mail

Michelle Bonvini

Aalborg University

Lead Author

E-mail

Silvia Lo Vecchio

Aalborg University

Lead Author

E-mail

Lars Arendt-Nielsen

PhD

Aalborg University

Lead Author

E-mail

Topics

  • Mechanisms: Psychosocial and Biopsychosocial