Current Pain and Headache Reports

, Volume 7, Issue 2, pp 116–126 | Cite as

Cognitive impairment in patients with chronic pain: The significance of stress

  • Robert P. Hart
  • James B. Wade
  • Michael F. Martelli


This review article examines the role of emotional distress and other aspects of suffering in the cognitive impairment that often is apparent in patients with chronic pain. Research suggests that pain-related negative emotions and stress potentially impact cognitive functioning independent of the effects of pain intensity. The anterior cingulate cortex is likely an integral component of the neural system that mediates the impact of pain-related distress on cognitive functions, such as the allocation of attentional resources. A maladaptive physiologic stress response is another plausible cause of cognitive impairment in patients with chronic pain, but a direct role for dysregulation of the hypothalamic-pituitary-adrenocortical axis has not been systematically investigated.


Chronic Pain Pain Intensity Cortisol Level Fibromyalgia Anterior Cingulate Cortex 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Current Science Inc 2003

Authors and Affiliations

  • Robert P. Hart
    • 1
  • James B. Wade
    • 1
  • Michael F. Martelli
    • 1
  1. 1.Department of PsychiatryVCU Health SystemRichmondUSA

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