Evidence map›Paper›PMID 40626344›Full record

Trial reportEuropean journal of pain (London, England)2025

Cognitive Function in Patients With Complex Regional Pain Syndrome (CRPS).

S Liesto, T Aho, S K Jääskeläinen, M Hietanen, E Kalso

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of pain (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04439669 (Complex Regional Pain Syndrome - Diagnostics, Pathophysiological Mechanisms, and Response to Treatment With Noninvasive Brain Stimulation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04439669 nacompletednot on this map

Complex Regional Pain Syndrome - Diagnostics, Pathophysiological Mechanisms, and Response to Treatment With Noninvasive Brain Stimulation

TypeinterventionalSponsorHelsinki University Central HospitalRan2017 to 2022Enrolled62ConditionsTranscranial Magnetic Stimulation, Complex Regional Pain Syndrome of Upper Limb (Disorder)ArmsSham nrTMS and open phase, Active nrTMS and open phase
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Cognitive Function in Patients With Complex Regional Pain Syndrome (CRPS).European journal of pain (London, England) · 2025
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

S LiestoDept. of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0002-3327-4986
T AhoDept. of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0003-3818-2623
S K JääskeläinenDepartment of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland.
M HietanenNeurocenter, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0002-1448-9738
E KalsoDept. of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0002-4899-605X

Funding

Finnish Association for the Study of PainFinnish Governmental Research FundingHelsinki University Hospital Research Funds from the Dept. of Anaesthesiology, Intensive Care and Pain Medicine
6 · The paper itself

Abstract

backgroundComplex Regional Pain Syndrome (CRPS) is characterised by pain, sensory, vasomotor, sudomotor, motor, and trophic symptoms, with cognitive symptoms also reported. This study aimed to examine the neuropsychological profile of patients with meticulously diagnosed CRPS 1 and 2.

methodsA neuropsychological examination was conducted in 54 CRPS patients. The test battery included Block Design and Similarities from Wechsler Adult Intelligence-IV, word list learning and delayed recall, and Digit Span from Wechsler Memory Scale-III, Trail Making Test (TMT), verbal and drawing fluency, Brixton, Manikin and Bourdon-Wiersma tests. Patients performing below -0.67 SD of the performance of a healthy Finnish population in ≥ 3 tests were classified as having cognitive decline. Questionnaires included Insomnia Severity Index, Beck Depression Inventory-II, CRPS Severity Scale, Disabilities of the Arm, Shoulder and Hand, Pain Catastrophizing Scale, Resilience Scale-14, Brief Pain Inventory, Insomnia Severity Index and State Trait Anxiety Inventory. Patients were asked about subjective cognitive difficulties.

resultsA subgroup comprising 30% of the CRPS patients showed cognitive decline. Higher pain catastrophising was associated with poorer test performance in TMT Part A. There were no differences between left and right sides on the visual attention test. Subjective cognitive difficulties were not associated with objective cognitive test performance. Cognitive functioning did not differ between CRPS 1 and 2 patients.

conclusionsThis study elucidates how CRPS affects cognitive functioning, important information when tailoring multidisciplinary rehabilitation to CRPS patients. Psychological factors may have a stronger impact on subjective cognitive difficulties than on objective test performances. SIGNIFICANCE STATEMENT: CRPS is an enigmatic syndrome with multifactorial origins, leading to chronic, disabling pain due to progressing neuroplastic alterations in the central nervous system. This study adds comprehensive novel information about cognitive function in CRPS, as, except for lateralised cognitions and body perception, cognitive domains have not previously been extensively studied in CRPS patients. Cognitive decline in 30% of patients indicates that neuropsychological assessment should be included in the diagnostics, and results considered in the rehabilitation of CRPS patients.

trial registrationClinicalTrials.gov identifier: NCT04439669.

Indexed as

CognitionCognitive DysfunctionComplex Regional Pain SyndromesAdultAgedCatastrophizationFemaleHumansMaleMiddle AgedNeuropsychological TestsPain Measurement

Identifiers

PMID40626344
PMCPMC12235581

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.