Chronic low back pain is associated with compromised cognitive function: A systematic review and meta-analysis

Area of Science:

• Neuroscience
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Chronic low back pain (CLBP) is a prevalent condition affecting millions globally.
• Cognitive function deficits have been anecdotally reported in individuals with CLBP.
• A systematic review and meta-analysis is needed to consolidate existing evidence on cognitive function in CLBP.

Purpose of the Study:

• To compare domain-specific cognitive function between adults with CLBP and pain-free controls.
• To systematically review and meta-analyze studies assessing cognitive performance in CLBP.
• To evaluate the certainty of evidence regarding cognitive function in CLBP.

Main Methods:

• Searched PubMed, CINAHL, PsycINFO, EMBASE, and CENTRAL databases.
• Conducted a pairwise random-effects meta-analysis using Hedges' g.
• Assessed the certainty of evidence using the GRADE approach and risk of bias using the JBI Critical Appraisal Checklist.

Main Results:

• Twenty-six studies with 5572 participants were included.
• Adults with CLBP performed significantly worse in executive function, global cognition, memory, motor skills, and processing speed compared to controls.
• No significant differences were found in attention, language, or perception, though evidence certainty was very low for most domains.

Conclusions:

• CLBP is associated with impairments in executive function, memory, motor skills, and processing speed, with very low certainty of evidence.
• CLBP may be linked to slightly worse global cognition, with low certainty of evidence.
• Assessing cognitive function in adults with CLBP is warranted, despite a lack of evidence on causal mechanisms.