The effect of pain on cognitive function: A review of clinical and preclinical research

Moriarty, Orla; McGuire, Brian E.; Finn, David P.

doi:10.1016/j.pneurobio.2011.01.002

Cited by 1,122Pain Mechanisms and TreatmentsPain Management and Opioid UseMusculoskeletal pain and rehabilitation

The effect of pain on cognitive function: A review of clinical and preclinical research

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Moriarty, Orla, McGuire, Brian E., Finn, David P.·2011·Progress in Neurobiology

DOI 10.1016/j.pneurobio.2011.01.002

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Abstract

Cognitive impairment is commonly associated with the pain experience. This impairment represents a major obstacle to daily activities and rehabilitation, especially in the chronic pain population. Here we review clinical and preclinical studies that have investigated pain-related alterations in cognition. These include impaired attentional, executive and general cognitive functioning. We describe the anatomical, neurochemical and molecular substrates common to both cognitive processing and supraspinal pain processing, and present the evidence for their involvement in pain-related cognitive impairment. We also examine the added complexity of cognitive impairment caused by analgesic medications and how this can further impact on morbidity in chronic pain patients. The need for a better understanding of the mechanisms of both pain-induced and treatment-related cognitive impairment is highlighted. Further research in this area will aid our understanding of patient symptoms and their underlying pathophysiology, ultimately leading to increased provision of guided therapy.

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Physical pain comes at a price in the form of reduced executive functioning.
“but it comes at a price in the form of reduced executive functioning (Baker et al. 2016; Eccleston and Crombez 1999; Moriarty, McGuire, and Finn 2011).”
From Human Capital and Administrative Burden: The Role of Cognitive Resources in Citizen‐State Interactions (2020) · cites this paper as Moriarty, McGuire, and Finn 2011
Section 2.4 reports that executive-type functions are affected in many chronic-pain patients, supporting the core association. But it also describes studies finding no deficit, and Section 2.5 says the direct effect of pain on cognition is difficult to establish. The claim presents reduced executive functioning as a general, definite cost of physical pain, which goes beyond those findings. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Chronic pain is associated with accelerated loss of gray matter in the prefrontal cortex, the neural center of executive functioning.
“For instance, brain morphology studies have shown chronic pain to be associated with accelerated loss of gray matter in the prefrontal cortex, meaning that the brain region, which is considered the neural center of executive functioning, physically shrinks in response to chronic pain (Apkarian et al. 2004; Moriarty, McGuire, and Finn 2011).”
From Human Capital and Administrative Burden: The Role of Cognitive Resources in Citizen‐State Interactions (2020) · cites this paper as Moriarty, McGuire, and Finn 2011
Section 3.1.2 (page not available) reports faster overall grey-matter loss in chronic-pain patients, reduced dorsolateral prefrontal cortex volume, and the PFC’s role in executive functioning. It does not establish that loss is accelerated specifically in the PFC or that chronic pain causes that region to shrink, as the citing sentence suggests. (LLM, conf=0.87)
Experimental — accuracy not yet measured
The very experience of having CP, the associated uncertainty, and the potential drain of pain on cognitive resources are together likely to further muddy the process of threat appraisal and coping skills development.
“However, we posit that the very experience of having CP, the associated uncertainty, and the potential drain of pain on cognitive resources [41], are together likely to further muddy the process of threat appraisal and coping skills development.”
From "Why Isn't It Going Away?": A Qualitative Exploration of Worry and Pain Experiences in Adolescents with Chronic Pain. (2021) · cites this paper as [41]

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Authors: Moriarty, O., McGuire, B. E., & Finn, D. P.
Affiliations: Ollscoil na Gaillimhe – University of Galway (IE)
Corresponding author: Finn, David P.
ORCID: Moriarty, Orla
McGuire, Brian E.
Finn, David P.
Venue: Progress in Neurobiology
Publisher: Elsevier BV
Published: 2011-03
Volume: 93
Issue: 3
Pages: 385-404
ISSN: 0301-0082 (ISSN-L)
DOI: 10.1016/j.pneurobio.2011.01.002
OpenAlex: W2098284778
Semantic Scholar: 8254dfd524d19bd43732270c9b8b8f8daa033835
Cited by: 1,122
References: 257
Citations by year: 2026: 72 · 2025: 111 · 2024: 102 · 2023: 82 · 2022: 75 · 2021: 110 · 2020: 86 · 2019: 80 · 2018: 78 · 2017: 66 · 2016: 72 · 2015: 64 · 2014: 46 · 2013: 43 · 2012: 21
FWCI: 26.82
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Progress in Neurobiology (publishedVersion)
PubMed (publishedVersion)
Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (acceptedVersion, cc-by-nc-nd)
University of Galway Research Repository (acceptedVersion, cc-by)
ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
Research Repository UCD (University College Dublin) (cc-by)
Funders: University College London
Topics: Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: chronic pain, attention, executive function, analgesic side effects, supraspinal pain processing, rehabilitation
MeSH terms: Analgesics, Animals, Brain, Cognition, Cognition Disorders, Humans, Neuropsychological Tests, Pain

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The effect of pain on cognitive function: A review of clinical and preclinical research

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