目的:先前的研究表明,实验性疼痛敏感性与认知功能有关。这项研究的目的是在大量基于人群的样本中评估这种关系。
方法:我们纳入了以人群为基础的Tromsø研究第七波中的5,753名参与者(年龄40-84岁),他们接受了认知测试和实验性疼痛评估。并且可以获得关于协变量的信息。使用认知测试的标准化分数拟合Cox回归模型(12字即时回忆测试,数字符号编码测试,和迷你精神状态检查[MMS-E])作为自变量,冷加压或袖带压力疼痛耐受性作为因变量。对推定的混杂因素进行了统计调整,即,年龄,性别,教育,吸烟,锻炼,收缩压,身体质量指数,表明焦虑或抑郁的症状,镇痛药的使用,和慢性疼痛。
结果:在多变量分析中,耐冷压时间与12字即时召回测试的测试分数显着相关(风险比[HR]0.93,95%置信区间[CI]0.90-0.97,p<0.001),数字符号编码测试(HR0.94,95%CI0.89-0.98,p=0.004),和MMS-E(HR0.93,95%CI0.90-0.96p<0.001)。对袖带压力测量的耐受性与12字即时回忆(HR0.94-0.97,p<0.001)和数字符号编码测试得分(HR0.93,95%CI0.89-0.96,p<0.001)显着相关,而与迷你精神状态检查得分没有显着关联(HR0.98,95%CI0.95-1.00,p=0.082)。
结论:较低的疼痛耐受性与认知测试表现较差相关。
OBJECTIVE: Previous studies have suggested that experimental pain sensitivity is associated with cognitive function. The aim of this study is to assess this relationship in a large population-based sample.
METHODS: We included 5,753 participants (aged 40-84 years) from the seventh wave of the population-based Tromsø Study who had been examined with cognitive tests and experimental pain assessments, and for whom information on covariates were available. Cox regression models were fitted using standardized scores on cognitive tests (12-word immediate recall test, digit symbol coding test, and Mini-Mental State Examination [MMS-E]) as the independent variable and cold pressor or cuff pressure pain tolerance as the dependent variables. Statistical adjustment was made for putative confounders, namely, age, sex, education, smoking, exercise, systolic blood pressure, body mass index, symptoms indicating anxiety or depression, analgesic use, and chronic pain.
RESULTS: In multivariate analysis, cold pressor tolerance time was significantly associated with test scores on the 12-word immediate recall test (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.90-0.97, p < 0.001), the digit symbol coding test (HR 0.94, 95% CI 0.89-0.98, p = 0.004), and the MMS-E (HR 0.93, 95% CI 0.90-0.96 p < 0.001). Tolerance to cuff pressure algometry was significantly associated with 12-word immediate recall (HR 0.94-0.97, p < 0.001) and Digit Symbol Coding test scores (HR 0.93, 95% CI 0.89-0.96, p < 0.001) while there was no significant association with Mini Mental State Examination test score (HR 0.98, 95% CI 0.95-1.00, p = 0.082).
CONCLUSIONS: Lower pain tolerance was associated with poorer performance on cognitive tests.