The interaction between pain and cognition: on the roles of task complexity and pain intensity

Elisabeth J Lier; Clementina M van Rijn; Marjan de Vries; Harry van Goor; Joukje M Oosterman

doi:10.1515/sjpain-2021-0119

The interaction between pain and cognition: on the roles of task complexity and pain intensity

Scand J Pain. 2021 Nov 3;22(2):385-395. doi: 10.1515/sjpain-2021-0119. Print 2022 Apr 26.

Authors

Elisabeth J Lier¹, Clementina M van Rijn², Marjan de Vries¹, Harry van Goor¹, Joukje M Oosterman²

Affiliations

¹ Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
² Radboud University, Donders Institute for Brain, Cognition and Behaviour Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands.

PMID: 34727588
DOI: 10.1515/sjpain-2021-0119

Abstract

Objectives: The interaction between pain and cognition includes a concurrent negative effect of pain on cognitive performance and an analgesic effect of cognitive distraction on pain experience. The purpose of this exploratory study was to investigate the role of pain intensity and task complexity on this interaction.

Methods: Two experiments were conducted in healthy volunteers. In both experiments, participants completed 3 conditions: a pain only condition (consisting of the cold pressor test), a cognition only condition (consisting of the cognitive task) and a combined condition (concurrent administration of the cold pressor and cognitive task). In experiment I, participants performed one out of three possible tasks that differed in cognitive load (low, medium, high). In experiment II the parameters of the pain stimulus, induced by a cold pressor test, were adapted and only the high load cognitive task was employed. Pain scores, reaction times, and accuracy rates were recorded.

Results: In experiment I, cognitive distraction significantly decreased pain scores, irrespective of the cognitive load of the task. Pain did not affect cognitive performance. In experiment II, pain diminished accuracy rates. No effect of cognitive distraction on pain was observed. Individual characteristics did not noticeably influence the interaction between pain and cognition.

Conclusions: The results of this study suggest a two-way interaction, however no evidence for a simultaneous bidirectional relationship was found. Cognitive distraction successfully reduces pain, up until a certain point where this relationship is reversed, and pain starts to interfere with cognitive performance. This may imply that priorities shift at a certain pain-threshold, however further research should confirm this hypothesis. This study could contribute to further understanding of cognitive mechanisms related to pain perception.

Keywords: cognition; cognitive performance; distraction; pain.

MeSH terms

Attention*
Cognition
Humans
Pain Measurement
Pain Threshold / psychology
Pain* / psychology