Alteraciones neuropsicológicas en pacientes con dolor crónico: Revisión sistemática desde una perspectiva diagnóstica actualizada

Resumen

La Organización Mundial de la Salud, en la última revisión de la Clasificación Internacional de Enfermedades (CIE-11), introdujo una nueva clasificación para el dolor crónico, con una etiología multifactorial y sin causa médica identificable, denominada “dolor crónico primario”. Dada su reciente conceptualización, el presente trabajo es una de las primeras revisiones sistemáticas centradas en analizar las alteraciones neuropsicológicas asociadas a dicho diagnóstico. Siguiendo la metodología PRISMA, para este análisis se seleccionaron estudios publicados

entre 2012 y 2024 en las bases de datos PubMed, Medline, Scopus y PsycInfo. La calidad metodológica de los estudios incluidos se evaluó mediante la escala Newcastle-Ottawa, adaptada para estudios transversales. Un total de 18 estudios revisados por pares cumplieron con los criterios de inclusión, todos ellos centrados en la evaluación del funcionamiento cognitivo en adultos con dolor crónico primario, específicamente en los subtipos de dolor musculoesquelético crónico primario (DMCP) y dolor visceral crónico primario (DVCP). Los resultados muestran que los pacientes con dolor crónico primario suelen presentar déficits principalmente en atención selectiva, así como alteraciones variables en memoria y funciones ejecutivas. Además, se identificaron correlaciones entre una mayor intensidad del dolor y un mayor deterioro cognitivo, y los estudios de neuroimagen revelaron patrones de conectividad funcional alterada en regiones cerebrales clave implicadas en la autorregulación emocional y el procesamiento del dolor. Los hallazgos evidenciados refuerzan la necesidad de adoptar enfoques multidisciplinares que integren la evaluación neuropsicológica en el abordaje clínico del dolor crónico primario. Esta revisión proporciona una base conceptual tanto para futuras investigaciones como para la formulación de estrategias de intervención que busquen mejorar la calidad de vida de los pacientes afectados por este diagnóstico.

Palabras clave

dolor crónico primario

alteraciones neuropsicológicas

déficit cognitivo

atención

revisión sistemática

Citas

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