Executive function in chronic pain patients

Executive function in chronic pain patients and healthy controls: Different cortical activation during response inhibition in fibromyalgia – free full-text  /PMC3715316/  – Dec 2011

The primary symptom of fibromyalgia (FM) is chronic, widespread pain; however, patients report additional symptoms including decreased concentration and memory.

Performance based deficits are seen mainly in tests of working memory and executive function.

Neural correlates of executive function were investigated in 18 FM patients and 14 age-matched HCs during a simple go/no-go task (response inhibition) while they underwent functional magnetic resonance imaging (fMRI).  

Since this study used only fibromyalgia patients, why is the study titled as concerning “chronic pain patients” in general?

Yes, fibromyalgia patients have chronic pain, but not all chronic pain patients have fibromyalgia. Fibromyalgia patients are a more specific subset of chronic pain patients.

Generally, PubMed studies are precisely titled and specify *exactly* what was studied, so I find this title very unusual.

Performance was not different between FM and HC, in either reaction time or accuracy.

However, fMRI revealed that FM patients had lower activation in

  • the right pre-motor cortex,
  • supplementary motor area (SMA),
  • mid cingulate cortex (MCC),
  • putamen and,
  • after controlling for anxiety, in the right insular cortex (IC) and right inferior frontal gyrus (IFG).

A hyper-activation in FM patients was seen in the right inferior temporal gyrus/fusiform gyrus.

Despite the same RTs and accuracy, FM patients show less brain activation in cortical structures in the inhibition network (specifically in areas involved in response selection/motor preparation) and the attention network along with increased activation in brain areas not normally part of the inhibition network.

We hypothesize that response -inhibition and pain perception may rely on partially overlapping networks, and that in chronic pain patients resources taken up by pain processing may not be available for executive functioning tasks such as response inhibition.

Compensatory cortical plasticity may be required to achieve performance on par with control groups.

These annotations are only from the abstract – the full-text article is here: Executive function in chronic pain patients and healthy controls: Different cortical activation during response inhibition in fibromyalgia.

I don’t fully understand how the different brain areas interact and balance each other so I can’t really understand the specifics of the article… and that bothers me.

My brain just can’t keep track of multiple things anymore. Decades of living with a shrieking pain alarm have probably fried my brain circuits.


1 thought on “Executive function in chronic pain patients

  1. dr boris

    I used to be able to multitask very well, I was also into weight lifting and excellent physical shape, those days are over 24/7 excruciating pain has taken everything out of me, every day I get up to live it all over again, it is never ending with no releif in sight…

    Liked by 1 person


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