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Cognitive Function in Patients With Complex Regional Pain Syndrome (CRPS)
S Liesto1,2, T Aho1, S K Jääskeläinen3
1Dept. of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
European Journal of Pain (London, England)
|July 8, 2025
Summary
Thirty percent of Complex Regional Pain Syndrome (CRPS) patients exhibit cognitive decline. Neuropsychological assessment is crucial for CRPS diagnostics and rehabilitation planning to address cognitive impairments effectively.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Complex Regional Pain Syndrome (CRPS) presents with diverse symptoms including pain, sensory, motor, and trophic changes, alongside reported cognitive difficulties.
- CRPS is a complex, disabling condition often stemming from central nervous system neuroplasticity.
- Previous research has limited exploration of cognitive domains in CRPS, excluding lateralized cognitions and body perception.
Purpose of the Study:
- To investigate the neuropsychological profile of patients diagnosed with Complex Regional Pain Syndrome (CRPS) types 1 and 2.
- To identify the prevalence of cognitive decline in CRPS patients.
- To explore the relationship between psychological factors and cognitive performance in CRPS.
Main Methods:
- A neuropsychological examination was administered to 54 CRPS patients using a battery of tests assessing intelligence, memory, executive functions, and attention.
- Cognitive decline was defined as performance below -0.67 SD compared to a healthy Finnish population in at least three tests.
- Validated questionnaires assessed insomnia, depression, pain catastrophizing, resilience, functional disability, and anxiety.
Main Results:
- A significant subgroup of 30% of CRPS patients demonstrated objective cognitive decline.
- Increased pain catastrophizing correlated with poorer performance on the Trail Making Test Part A.
- No significant differences in cognitive functioning were observed between CRPS 1 and CRPS 2 patients, nor between left and right-sided attention tests.
Conclusions:
- Cognitive decline is prevalent in 30% of CRPS patients, underscoring the need for neuropsychological assessment in diagnosis and rehabilitation.
- Psychological factors, such as pain catastrophizing, may disproportionately influence subjective cognitive complaints over objective test performance.
- Understanding the cognitive profile of CRPS patients is essential for tailoring effective multidisciplinary rehabilitation strategies.
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