ABSTRACT
The authors have studied cognitive functions and influencing factors in 64 patients with chronic low back pain. All patients have been examined using neurologic, neuroorthopedic, pathopsychological and neuropsychological methods. Patients have been divided into 2 groups according to their age: group 1 (aged 30-50 years) and group 2 (aged 51-60 years). Healthy controls were matched to patients for age, sex and education. Significant differences in neuropsychological testing, i.e. mental flexibility, delayed memory, psychomotor speed, which referred to the subtle cognitive impairment with executive function disturbances, were found in both groups of patients with chronic low back pain as compared to pain-free adults. Sensory-discriminative (pain intensity) and affective-emotional (negative emotions, in particular, anxiety) characteristics had the effect on cognitive functions in younger patients without depressive symptoms. Affective-emotional (anxiety, psychological distress) and cognitive characteristics (i.e. catastrophising) contributed to the cognitive disturbances in older patients.
Subject(s)
Cognition Disorders/physiopathology , Cognition/physiology , Low Back Pain/psychology , Psychomotor Performance/physiology , Adult , Chronic Disease , Cognition Disorders/etiology , Disease Progression , Female , Humans , Low Back Pain/complications , Male , Memory/physiology , Middle Aged , Psychological TestsABSTRACT
Chronic pain syndromes comprise a heterogeneous group of very common clinical conditions having important medical and social implications. The author briefly reviews evolution of the concepts of mechanisms and characteristics of neuropathic, nociceptic, and psychogenic pain and current approaches to the diagnosis and treatment of neuropathic pain syndromes and musculo-skeletal pains. The recommended therapeutic modalities for patients with chronic pains are based on the results of original studies conducted in the Department of Neural Diseases, I. M Sechenov Moscow Medical Academy, during the last years and recent data obtained in foreign clinics.
Subject(s)
Cognitive Behavioral Therapy/methods , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/therapy , Pain Management , Pain/diagnosis , Polyneuropathies/diagnosis , Polyneuropathies/therapy , HumansABSTRACT
We examined 143 patients, aged 18-65 years, with chronic low back pain, in 78 of patients diagnosed as chronic somatoform pain disorder (CSPD)--ICD-10 F45.4--and in 65 as chronic pain syndrome (CPS) caused by spine pathology (M48.0, M51.1, M54.4). Depressive symptoms predominated in CSPD patients, who exhibited more pronounced psychopathological disturbances and two-fold higher frequency of personality disorders, comparing to those with CPS. In CSPD patients pain severity and reaction to pain syndrome were significantly higher than in CPS patients. Psychodiagnostic study revealed higher expressed anxiety and depression as well as socio-psychological maladaptation in CSPD patients as compared to CPS ones. After neurological examination, significant between-group differences were found in the frequency of muscular-tonic myofacial, syndrome and iliosacral joint dysfunction.
