Emotion and Memory in Chronic Neuropathic Pain
The Role of Limbic Subcortical Structures and Cognition in Chronic Neuropathic Pain
University Health Network, Toronto
400 participants
Feb 12, 2024
OBSERVATIONAL
Conditions
Summary
Chronic pain affects one in four Canadians, leading to severe personal and societal costs. Over 70% of chronic pain patients report memory difficulties and fear having unexpected pain. Abnormalities in brain structures associated with emotion and memory, including the hippocampus and amygdala, can be affected by chronic pain. Understanding the relationship between chronic pain, structural brain changes, and cognitive functioning will lead to improved diagnosis, treatment, and outcomes in chronic pain disorders. In this project, the investigators will use advanced brain imaging techniques that assess the structure and function of the brain along with cognitive assessments to examine the overlap between chronic pain and emotion-memory processes. The study team will conduct the study using an excellent model of chronic pain-trigeminal neuralgia, a severe form of facial pain that responds well to surgical treatment. Brain images and cognitive data will be collected from participants before and after surgical treatment for pain. This information will be analyzed and compared with age- and sex-matched healthy individuals. This study will be the first to thoroughly investigate relationships between brain structure and function, cognition (memory, emotion), and promises to impact our understanding of chronic neuropathic pain conditions.
Eligibility
Inclusion Criteria8
- Age between 35 and 60 years old
- Absence of other active major neurological or psychiatric disorders
- Absence of MRI contraindications
- Able to communicate sufficiently to complete tasks and questionnaires
- Montreal Cognitive Assessment (MoCA) score greater than 23/30 (MoCA ≤23/30 could indicate severe cognitive impairment)
- Experiencing TN pain over a period of 6 months
- Stable medication use
- Meet established diagnostic criteria for TN (ICHD-3)
Exclusion Criteria5
- Presence of other chronic pain/headache conditions
- Untreated hypertension or diabetes mellitus
- History of chronic drug or substance use disorder, chronic use of opioids or steroids, head trauma affecting cognitive performance,
- History/presence of active psychiatric illness and/or current use of psychoactive medication
- History of multiple sclerosis, skull base injury or tumours
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Interventions
* Pain questionnaires such as Numerical Pain Rating Scale is one of the most widely used multidimensional pain scales to assesses a person's pain based on the words they use to describe their pain. * Battery of Cognitive questionnaires = The cognitive test battery was designed to assess key cognitive abilities including attention, concentration, verbal learning and memory, verbal fluency, working memory and executive function as well as global cognitive functioning and fear and anxiety * Mnemonic Simulation Test and Rey Auditory Verbal Learning Test are the neuropsychological assessments designed to evaluate recognition and verbal memory, respectively. Both tasks have been shown to be very sensitive to hippocampal engagement and damage. * Memory-recall interview is an interview for the interviewees to recall the event from different perspectives, such as from the preadmission date, 2-week post- and 6-month post-surgical date. This supports the memory retrieval process.
Magnetic Resonance Imaging is a noninvasive medical imaging test that produces detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels. MRI scanners create images of the body using a large magnet and radio waves.
Locations(1)
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NCT06518421