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- Bothelius, Kristoffer, 1973-, et al.
(författare)
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Insomnia-related Memory Impairment in Individuals With Very Complex Chronic Pain
- 2019
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Ingår i: COGNITIVE AND BEHAVIORAL NEUROLOGY. - : LIPPINCOTT WILLIAMS & WILKINS. - 1543-3633 .- 1543-3641. ; 32:3, s. 164-171
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the specific effect of insomnia on neuropsychological functioning in patients with very complex chronic pain. Background: Individuals with insomnia disorder or chronic pain often experience cognitive deficits, with both conditions appearing to correlate with impairments in neuropsychological functions. As insomnia often occurs comorbid with chronic pain, distinguishing the differential effects of these two syndromes on an individual's neuropsychological functioning can be challenging. Comorbid depressive symptoms in these individuals, which may also affect cognitive function, may further obscure the associations between chronic pain, insomnia, and the neuropsychological profile. Methods: The neuropsychological function of 22 individuals with very complex chronic pain was assessed using specialized tests examining aspects of memory and executive functioning. The severity of insomnia, depression, and anxiety was measured using questionnaires, and pain levels were assessed using a visual analog scale. Pain medications were transformed to the morphine-equivalent daily dose. Results: Insomnia severity was found to predict memory function, accounting for 32.4% of the variance: A 1 SD increase in insomnia severity decreased memory function by 0.57 SD. The negative correlation between insomnia and memory was significant even after controlling for pain level, morphine-equivalent daily dose, and comorbid levels of anxiety and depression. Conclusions: Insomnia severity independently predicted memory function in patients with very complex chronic pain, even after controlling for other factors known to impair cognitive function. Insomnia may possibly explain some of the cognitive impairments related to chronic pain; thus, screening for, and treating, sleep disturbances may be a central aspect of chronic pain rehabilitation.
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| 2. |
- Laari, S. P. K., et al.
(författare)
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Executive Dysfunction Related to Binge Drinking in Ischemic Stroke
- 2020
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Ingår i: Cognitive and Behavioral Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 1543-3633. ; 33:1, s. 23-32
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent evidence has shown that cognitive dysfunction is associated with a history of binge drinking in adolescents who do not have an alcohol use disorder. Most previous studies with adults, however, have failed to show a link between cognitive dysfunction and subdiagnostic binge drinking, nor have any studies investigated the additive cognitive effect of binge drinking to ischemic stroke. Objective: To examine whether a pattern of cognitive dysfunction, especially executive and memory dysfunction, in patients with a first-ever ischemic stroke is associated with a history of subdiagnostic binge drinking. Methods: We studied 206 first-ever ischemic stroke patients (18-65 years) and 50 healthy, demographically comparable adults-both groups with no alcohol use disorder. After exclusion by matching, 189 patients and 39 healthy participants were included in our study (228 participants). The binge-drinking group included 76 participants; the non-binge-drinking group included 152. A multivariate analysis of covariance was used to compare nine cognitive functions between the two groups, with age, education, and stroke severity used as covariates. Results: Binge drinking had a significant negative effect on executive functions (P<0.001). The non-binge-drinking group outperformed the binge-drinking group on the Stroop Test (P=0.001), Trail Making Test (P=0.002), and a phonemic fluency test (P=0.005). The BingexStroke Severity interaction (P=0.037) indicated that a history of binge drinking increased the negative effect of stroke on executive functions. Conclusions: Subdiagnostic binge drinking may exacerbate the adverse effects of ischemic stroke on executive dysfunction.
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