Chronic pain is specifically associated with updating working memory: a longitudinal twin study

Area of Science:

• Psychology
• Neuroscience
• Genetics

Background:

• Worse executive function (EF) is associated with chronic pain, potentially contributing to pain chronification.
• It remains unclear if chronic pain involves general EF impairments or deficits in specific cognitive domains.
• The genetic underpinnings of the association between EF and chronic pain have not been investigated.

Purpose of the Study:

• To examine the phenotypic and genetic associations between executive functions and chronic pain in young adults.
• To determine if impairments in specific cognitive domains, such as updating working memory or shifting mental sets, are uniquely associated with chronic pain.
• To investigate the shared genetic risk factors between executive function and chronic pain.

Main Methods:

• Utilized data from 786 twins from the Colorado Longitudinal Twin Study, assessing executive functions at ages 23 and 28.
• Defined a Common EF factor, an Updating-specific factor, and a Shifting-specific factor from executive function tasks.
• Estimated phenotypic and genetic correlations between stable EF variance (ages 23-28) and self-reported chronic pain at mean age 28.1.

Main Results:

• Phenotypic analysis revealed a significant negative correlation between chronic pain and the Updating-specific EF factor (r = -0.21, P = 0.008).
• No significant phenotypic correlations were found between chronic pain and the Common EF factor, Shifting-specific factor, or EF variance unique to age 28.
• A twin model indicated significant shared genetic risk between chronic pain and the Updating-specific EF factor (rA = -0.46, P = 0.005), but not shared environmental risk.

Conclusions:

• Updating working memory shows a significant phenotypic and genetic relationship with chronic pain in young adults.
• Impairments in the ability to update working memory may play a mechanistic role in the development of chronic pain.
• These findings highlight the importance of cognitive factors, particularly working memory updating, in understanding chronic pain.