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PAIN MEDICINE

Disruption of Attention and Working Memory Traces in Individuals with Chronic Pain

Bruce D. Dick, PhD^*, and Saifudin Rashiq, MB, MSc, FRCPC^*

From the Departments of *Anesthesiology and Pain Medicine and Psychiatry, University of Alberta; and Multidisciplinary Pain Centre, University of Alberta Hospital, Edmonton, AB, Canada.

Address correspondence and reprint requests to Bruce D. Dick, PhD, Department of Anesthesiology and Pain Medicine, 8-120 Clinical Sciences Building, University of Alberta, Edmonton, AB, Canada T6G 2B7. Address e-mail to bruce.dick{at}ualberta.ca.

BACKGROUND: Research has found that chronic pain disrupts attention and that this disruption can lead to significant functional impairment and decreased quality of life. We conducted the present study to examine how attention and memory are disrupted by chronic pain.

METHODS: Computerized tests of working memory were given to participants with chronic pain along with a neuropsychological test of attention before and after procedures resulting in analgesia.

RESULTS: Two-thirds of participants with chronic pain had scores in the clinically impaired range on attentional tasks. These results were independent of age, education level, sleep disruption, and pain relief. Medication use was also recorded and is reported to account for potential effects of medication on task performance. Those participants with the highest level of impairment had significantly greater difficulties in maintaining a memory trace during a challenging test of working memory.

CONCLUSIONS: These findings point to a specific cognitive mechanism, the maintenance of the memory trace, that is affected by chronic pain during task performance. Cognitive function was not improved by short-term local analgesia.

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