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Cognitive flexibility training for chronic pain: a randomized clinical study.

Katherine J Holzer1, Marko S Todorovic2, Elizabeth A Wilson1

  • 1Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.

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|February 14, 2024
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Summary

Neurocognitive training may improve cognitive flexibility and reduce pain severity in individuals with chronic pain. This study offers insights for future clinical trials on pain management interventions.

Keywords:
Cognitive flexibilityNeurocognitive trainingPain interferencePain severity

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Area of Science:

  • Neuroscience
  • Pain Management
  • Cognitive Psychology

Background:

  • Cognitive flexibility is linked to chronic pain development.
  • The potential for improving cognitive flexibility in chronic pain patients remains unclear.

Purpose of the Study:

  • To investigate if a neurocognitive training program enhances cognitive flexibility and alleviates pain in chronic pain patients.
  • To assess the impact of daily neurocognitive training on pain severity and interference.

Main Methods:

  • A 5-week randomized controlled trial involving 145 chronic pain patients.
  • Participants engaged in daily 35-minute neurocognitive training focusing on cognitive flexibility, memory, attention, and speed.
  • Outcomes measured included neurocognitive performance, pain interference, and pain severity at baseline, 5 weeks, and 3 months.

Main Results:

  • The neurocognitive training group demonstrated significant improvements in neurocognitive performance at 5 weeks (d = 0.37), with a smaller effect at 3 months (d = 0.18).
  • Patients in the training group reported reduced pain severity at both 5 weeks (d = 0.16) and 3 months (d = 0.39).
  • Pain interference was significantly lower in the treatment group only at the 3-month follow-up (d = 0.20).

Conclusions:

  • Neurocognitive training may be a viable strategy to improve cognitive flexibility and reduce pain severity in chronic pain patients.
  • This research provides crucial effect size estimates for designing future randomized controlled trials on neurocognitive interventions for chronic pain.
  • Findings support the development of targeted interventions to manage chronic pain through cognitive enhancement.