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

Abstract

The World Health Organization, in the latest revision of the International Classification of Diseases (icd-11), introduced a new classification for chronic pain, characterized by a multifactorial etiology and the absence of an identifiable medical cause, termed “primary chronic pain.” Given its recent conceptualization, this study constitutes one of the first systematic reviews focused on analyzing the neuropsychological alterations associated with this diagnosis. Following the prisma methodology, studies published between 2012 and 2024 were selected from the PubMed, Medline, Scopus, and PsycInfo databases. The methodological quality of the studies included was assessed using the Newcastle-Ottawa Scale, adapted for cross-sectional studies. A total of 18 peer-reviewed studies met the inclusión criteria, all of which focused on the assessment of cognitive functioning in adults with primary chronic pain, specifically in the subtypes of primary chronic musculoskeletal pain (pcmp) and primary chronic visceral pain (pcvp). The results revealed that patients with primary chronic pain tend to exhibit deficits primarily in selective attention, as well as variable impairments in memory and executive functioning. Furthermore, correlations were identified between higher pain intensity and greater cognitive impairment, and neuroimaging studies revealed patterns of altered functional connectivity in key brain regions involved in emotional self-regulation and pain processing. The findings reinforce the need to adopt multidisciplinary approaches that integrate neuropsychological assessment into the clinical management of primary chronic pain. This review provides a conceptual basis for future research and for the development of intervention strategies aimed at improving the quality of life of patients affected by this condition.

Keywords

chronic primary pain

neuropsychological alterations

cognitive impairment

attention

systematic review

References

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