COSMIN database

Methods and Instruments to Evaluate Cognitive Function in Chronic Pain Patients: A Systematic Review

Ojeda, B., Failde, I., Duenas, M., Salazar, A., and Eccleston, C.
OBJECTIVE: We aimed to systematically review the methods and instruments used to evaluate cognitive function in chronic pain (CP) patients.

METHODS: A sensitive search strategy was designed using five databases. Based on the objectives and methodology, we selected cross-sectional studies on adults with chronic non-cancer pain in which cognitive function was assessed using validated instruments. The characteristics of the subjects, control groups, and other variables that might affect cognitive function, and the instruments used, were extracted from each article.

RESULTS: In the 42 articles identified, 53 instruments were used to assess cognitive function. Chronic pain criteria were defined in 83.3% of the articles and more than half (57.1%) included single diagnosis samples, with fibromyalgia being the most frequent studied (75%). Patients with prior cognitive impairment were excluded in 61.9% of the studies, and a control group was included in 64.3% of the studies. In most cases potential confounding variables were evaluated. More than 14% of the studies used self-report measures, and 73.8% used neuropsychological instruments, particularly for assessing attention (30%) and memory (27.5%). None of the instruments were specifically validated for pain patients and only five studies analyzed the psychometric properties of the instruments.

CONCLUSIONS: Various instruments and methods were used to assess cognitive function in CP patients, particularly fibromyalgia patients, but also other cohorts with well-defined CP. The instruments used had been validated, but not for pain populations, thus they require specific adaptation and validation to be used in CP patients. Certain recommendations are made in order to improve the evaluation of cognitive function in these patients.
Pain Med
Publication year:
Biological and physiological variables:
Biological and physiological variables
Functional status:
Cognitive/mental functioning
Adults (18-65)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
10/36 SRT - 10/36 Spatial Recall Test
12-word memorization and reproduction test
ACT - Auditory Consonant Trigrams test
Bourdon-Vos Test
BSI - Brief Symptom Inventory
CALT - Conditional Associative Learning Task (CALT)
CFT - Complex Figure Test
COC - Cuestionario de Olvidos Cotidianos
Code Memory Test
COWAT - Controlled Oral Word Association Test;
CRT - Continuous Reaction Time
CVLT-II - California Verbal Learning Test, Second edition
Design Fluency Test
Digit Symbol Substitution Test
EMF - Everyday Memory Failures Questionnaire
Free recall
FTT - Finger Tapping Test
Grooved Pegboard Test
IGT - Iowa Gambling Task
Kimura Recurring Recognition Figures Test
MASQ - Multiple Ability Self-Report Questionnaire
MIA - Metamemory in Adulthood Questionnaire
MMQ - Metamemory Questionnaire
MMSE - Mini-Mental State Examination   
MOQ - Memory Observation Questionnaire
N-task & V-task - Numerical Interference Task
Number sequence repetition test
PASAT - Paced Auditory Serial Additions Test
PMQ - Prospective Memory Questionnaire
Randt Memory Test
RAVEC - Test de Aprendizaje Verbal España-Complutense
RAVLT - Rey Auditory Verbal Learning Test
R/K procedure - Remember/Know procedure
Road Map Test
RST - Reading Span Test
SDMT - Symbol Digit Modalities Test (alias: SDMT-written version)
Shape recognition and line orientation tests of Benton
SIP - Sickness Impact Profile   
SST - Spatial Span Test
Stroop test(s) [alias: Visual Stroop Test] [alias: Auditory Stroop Test]
TEA - Test of Everyday Attention
Test Barcelona
Test Toulouse-Piéron
TMT - Trail Making Test
ToL - Tower of London Task [alias: London Tower]
Uchida-Kraepelin Test
Verbal Associations Test
WCST - Wisconsin Card Sorting Test
Wechsler Memory Scales - (WMS-R, WMS-III, WMS-IV)
WIS-A - Wechsler Intelligence Scales for Adults
Word Fluency Task
Word-Stem Completion Task
Zoo Map Test