Evidence map›Paper›PMID 40975688›Full record

ArticleBritish journal of anaesthesia2025

Association of nociplastic pain with executive function decline in a longitudinal cohort of middle-age adults: a prospective cohort study.

Eoin M Kelleher, Xin-You Tai, Andrew Schrepf, Trishna Rathod-Mistry, Thomas Nichols, Irene Tracey, Anushka Irani

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Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Eoin M KelleherNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA. Electronic address: ekelleher11@mgh.harvard.edu.
Xin-You TaiNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Andrew SchrepfChronic Pain and Fatigue Research Centre, University of Michigan, Ann Arbor, MI, USA.
Trishna Rathod-MistryNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Thomas NicholsNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Irene TraceyNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Anushka IraniNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Division of Rheumatology, Mayo Clinic Florida, Jacksonville, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic pain, frequently report cognitive problems ('brain fog'), particulary those with nociplastic pain, which involves dysregulated pain processing. However, the association with objective executive dysfunction and decline over time is unclear. We examined whether nociplastic pain severity is associated with executive dysfunction and decline, and explored which factors, such as sex or associated non-pain symptoms, mediate this relationship.

methodsWe conducted a prospective cohort study using UK Biobank. Baseline cognitive assessments (2017-20), a pain questionnaire (2019), and follow-up cognitive assessments (2021-2) were analysed. Nociplastic pain severity was measured using the fibromyalgia index (0-31), a continuous measure of widespread pain and symptom severity. A latent executive function measure was derived using confirmatory factor analysis. Cross-sectional associations were examined using linear regression, and longitudinal structural equation modelling assessed cognitive decline. Mediation analysis evaluated indirect effects of abnormal sleep duration, anxiety, depression, brain fog, fatigue, and pain qualities.

resultsWe included 35 423 participants (median age 65 yr; 52% female). Greater nociplastic pain severity was associated with worse executive function cross-sectionally (β=-0.49 centiles per 1 point increase in fibromyalgia index; 95% confidence interval -0.59 to -0.39), with a stronger effect in males. However, nociplastic pain severity was not associated with a faster rate of executive function decline. Abnormal sleep duration, anxiety, pain intensity, and neuropathic pain features partially mediated the cross-sectional association.

conclusionsNociplastic pain severity is associated with worse executive function but reassuringly does not suggest worse cognitive decline. Abnormal sleep duration, anxiety, and pain intensity are highlighted as potential intervention targets.

Indexed as

chronic paincognitionepidemiologyexecutive functionnociplastic painpainUK Biobank

Identifiers

PMID40975688
PMCPMC12799397

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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.