Factors related to cognitive impairment in fibromyalgia, neuropathic and musculoskeletal pain patients.

B Ojeda

a, M Dueñas

b, A Salazar

a, JA Mico

c, LM Torres

d, I Failde

a

aPreventive Medicine and Public Health Area, The Observatory of Pain (External Chair of Pain), University of Cádiz, Spain. bSalus Infirmorum Faculty of Nursing, University of Cádiz.

cDepartment of Neuroscience, Pharmacology and Psychiatry, CIBER of Mental Health, CIBERSAM, Instituto de Salud Carlos III, University of Cádiz, Plaza Fragela 9, 11003 Cádiz, Spain. dDepartment of Anesthesiology-Critical Care and Pain Management, University Hospital “Puerta del Mar”, Avenue Ana de Viya 21, 11009 Cádiz, Spain.

To compare the cognitive function of patients diagnosed with neuropathic pain (NP), musculoskeletal pain (MSK) and

fibromyalgia (FM), and to analyse the factors associates to cognitive function in each group.

Cognitive performance (Test Your Memory scale: TYM).

Pain intensity (Visual Analogue Scale: VAS).

Anxiety and depression (Hospital Anxiety and Depression scale: HADs)

Sleep quality (MOS-sleep).

Results

Conclusion These results highlight the importance of assessing cognitive performance in CP patients depending on the type of pain and analysing the effect of the emotional state of the patient, especially if depression is present.

Acknowledgments: This work was supported by the External Chair of Pain, collabo-

ration between the University of Cádiz and the Grünenthal Foundation. The Grünen-

thal Foundation is a private non-profitable organization that promotes the dissemi-

nation of scientific knowledge and supports research.

Aim of Investigation

Methods

Poster Presentation Board Number: 39 Presentation Date: Friday, September 30 2016

Presentation Time: 3:15-4:15 PM

External Chair of Pain Grünenthal Foundation -University of Cádiz

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Our web site: https://observatoriodeldolor.com/

Observatory of Pain A research group for the study of pain in our social environment

Avda. Ana de Viya, 52 11009 Cádiz (SPAIN)

Design

Subjects

254 chronic pain patients

72 controls (no pain)

104 neuropatic pain

99 musculoskeletal

51 fibromyalgia

Linear regression models to analyse the relationships between cognitive

performance and intensity and duration of pain, sleep quality and anxiety

and depression.

Cross-sectional study

Instruments

and variables

Statistical

analyses

Quadratic relationship between pain duration and

TYM score (NP: n=104).

Demographic and clinical characteristics of the sample. Chronic Pain

Patients (254) Controls (72) p Neuropathic

Pain (104) Musculoskele-tal Pain (99)

Fibromyalgia (51)

p

Sex (%) Men Women

36.2 63.8

43.1 56.9

0.18

47.1 52.9

41.4 58.6

3.9 96.1

<0.001

Age Mean (SD) 47.42 (8.8) 40 (11.11) <0.001 45.59 (8.68) 47.63 (9.42) 50.76 (6.7) 0.002 Academic level No education 1ary education 2ary/Vocational training University studies

11.8 39

40.9 8.3

5.6 22.2 36.1 36.1

<0.001

10.6 47.1 37.5 4.8

14.1 34.3 40.4 11.1

9.8 31.4 49 9.8

0.27

Co-morbidity (% yes) 74.4 43.1 <0.001 73.1 67.7 90.2 0.010 Pharmacological drugs (% yes) Antidepressant BZD Anticonvulsivants Opioids NSAID

83.9 32.2 42.1 45.7 53.9 8.3

20.8 5.6 8.3 1.4 0

2.8

<0.001 <0.001 <0.001 <0.001 <0.001 0.082

89.4 33.7 39.4 52.9 61.5 7.7

75.8 27.3 39.4 44.4 52.5 10.1

88.2 58.8 52.9 33.3 41.2 5.9

0.019 0.001 0.216 0.068 0.054 0.648

Intensity Mean (SD) 6.65 (1.87) - - 6.63 (1.85) 6.7 (2) 6.59 (1.67) 0.86 Duration Mean (SD) 108.5 (97.6) - - 92.11 (82.7) 102 (97.42) 154.53 (112.7) 0.001 HADs-A Mean (SD) 9.45 (4.93) 3.61 (4.05) <0.001 9.01 (4.84) 8.89 (5) 11.43 (4.57) 0.004 HADs-D Mean (SD) 7.88 (5.18) 2.06 (2.3) <0.001 7.92 (5.3) 7.35 (5.28) 8.82 (4.66) 0.15 Index 9 Mean (SD) 52.41 (21.68) 29.34 (13.21) <0.001 52.41 (21.78) 49.42 (22.4) 58.19 (19.1) 0.072 Optimal sleep (%) 19.7 52.8 <0.001 18.3 24.2 13.7 0.28 HADs-A: hospital and depression scale-Anxiety; HADs-D: hospital and depression scale-Depression; Optimal sleep: 6 to 8 hours sleep.

Fibrmyalgia Variables B (SE) CI (95%) p

Academic level 1ary education 2ary/Vocational training University studies HADs_Depression Intensity Intensity*Depression

2.99(1.86) 5.85(1.79) 7.61(2.35) -1.08(0.42) -0.57(0.64) -1.51(0.46)

(-0.77;6.75) (2.24;9.46) (2.87;12.35) (-1.92;-0.23) (-1.87;0.71) (-2.44;-0.58)

0.12 0.002 0.002 0.014 0.37 0.026

n=49; R2 corrected = 0.36

All Chronic Pain Patients Variables B (SE) CI (95%) p

Age Academic level 1ary education 2ary/Vocational training University studies HADs_Depression

-0.082(0.03)

4.047(0.97) 6.702(0.97) 8.759(1.34) -0.288(0.06)

(-0.15;-0.02)

(2.14;5.96) (4.79;8.61) (6.11;11.41) (-0.4;-0.17)

0.014

<0.001 <0.001 <0.001 <0.001

N=254; R2 corrected: 0.32

Musculoskeletal Pain Variables B (SE) CI (95%)

(Inf; Sup) p

Age Academic level 1ary education 2ary/Vocational training University studies HADs_Depression

-0.09(0.05)

3.04(1.35) 6.42(1.33) 6.89(1.75) -0.37(0.08)

(-0.18;-0.00)

(0.37;5.72) (3.78;9.06) (3.41;10.36) (-0.53;-0.2)

0.046

0.026 <0.001 <0.001 <0.001

n=99; R2 corrected = 0.41

Neuropathic Pain Variables B (SE) CI (95%)

(Inf; Sup) p

Age Academic level 1ary education 2ary/Vocational training University studies HADs_Depression Duration (quadratic) Duration (lineal)

-0.12(0.06)

5.29(1.78) 7.67(1.84) 12.96(2.88) -0.19(0.1)

1.4x10-4(7x10-5) -0.03(0.02)

(-0.24; 0.01)

(1.77;8.82) (4.01;11.32) (7.25;18.67) (-0.39;0.02)

(1x10-6;2.8x10-4) (-0.06;0.01)

0.06

0.004 <0.001 <0.001 0.072 0.048 0.20

n=104; R2 corrected = 0.29

Global model

Models for each pain group