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Advisor(s)
Abstract(s)
A dor é uma experiência subjetiva difícil de medir. Os estudos têm mostrado que
os relatos de dor dos indivíduos revelam ampla variabilidade, mas as razões subjacentes
a essa variabilidade continuam por esclarecer. Uma das possibilidades é que a memória
de curto prazo possa constituir um fator importante. A fibromialgia (FM) uma síndrome
de dor crónica caracterizada por dor e alterações no funcionamento cognitivo, pelo que
constitui um modelo útil para a compreensão destes mecanismos. Este estudo teve como
objetivo avaliar a variabilidade nos relatos de dor experimental e verificar se esta se
relaciona com o desempenho cognitivo numa tarefa de memória de curto-prazo.
Foram recrutados 29 participantes com FM e 15 indivíduos saudáveis que
realizaram a tarefa de memória de dígitos da Escala de Memória de Wechsler e foram
sujeitos a um protocolo de avaliação de dor que incluía avaliação da variabilidade da dor
experimental, através do FAST, avaliação da sensibilidade à dor, através de tarefas de
limiares de diferentes modalidades (elétrica, térmica e de pressão) e tolerância térmica, e
avaliação de características clínicas, através do Inventário Resumido da Dor,
Questionários de Impacto da Fibromialgia, FACIT e Escala Hospitalar de Depressão e
Ansiedade.
Os resultados mostraram que os indivíduos com FM revelaram menor
variabilidade nos relatos de dor experimental, ou seja, foram mais precisos na avaliação
da dor do que os indivíduos do grupo de controlo. No grupo de doentes, quanto melhor o
desempenho na tarefa de memória menor a variabilidade.
Estes resultados sugerem que a experiência da dor clínica poderá melhorar a
precisão e que competências de memória poderão ser essenciais para uma boa capacidade
de reportar a dor. Uma melhor compreensão dos mecanismos cognitivos envolvidos na
variabilidade da dor poderá ter implicações na melhoria da avaliação desta experiência e
assim, contribuir para melhorias no diagnóstico e tratamento da dor.
Pain is a complex and subjective experience and, as such difficult to measure. Previous studies have found that that there is wide variability in the individuals’ pain reports, but the reasons underlying this variability is yet to be understood. One of the possibilities is that short-term memory may constitute an important factor. FM is a chronic pain syndrome characterized by pain and changes in cognitive functioning, and as such may be a useful model for understanding these mechanisms. This study aimed to investigate the experimental pain reporting variability and its relations with the cognitive performance in a short-term memory task. Twenty nine participants with FM and fifteen healthy individuals were recruited and performed the digit memory task of the Wechsler Memory Scale and a pain assessment protocol that included evaluation of the experimental pain reporting variability, using FAST, evaluation of pain sensitivity using thresholds of different modalities (electrical, thermal and pressure) and thermal tolerance tasks, and evaluation of clinical characteristics, through the Brief Pain Inventory, Fibromyalgia Impact Questionnaires, FACIT and Hospital Depression and Anxiety Scale. The results indicated that individuals with FM had lower experimental pain reporting variability, that is, they were more reliable in assessing pain than individuals in the control group. In the patient group, the better the performance in the memory task, the lower the variability. These results suggest that the experience of clinical pain may improve the pain reporting reliability and that memory skills may be essential for pain reporting ability. A better understanding of the cognitive mechanisms involved in the variability of pain reporting may have implications for improving the evaluation of this experience and thus contribute to improvements in diagnosis and treatment of pain.
Pain is a complex and subjective experience and, as such difficult to measure. Previous studies have found that that there is wide variability in the individuals’ pain reports, but the reasons underlying this variability is yet to be understood. One of the possibilities is that short-term memory may constitute an important factor. FM is a chronic pain syndrome characterized by pain and changes in cognitive functioning, and as such may be a useful model for understanding these mechanisms. This study aimed to investigate the experimental pain reporting variability and its relations with the cognitive performance in a short-term memory task. Twenty nine participants with FM and fifteen healthy individuals were recruited and performed the digit memory task of the Wechsler Memory Scale and a pain assessment protocol that included evaluation of the experimental pain reporting variability, using FAST, evaluation of pain sensitivity using thresholds of different modalities (electrical, thermal and pressure) and thermal tolerance tasks, and evaluation of clinical characteristics, through the Brief Pain Inventory, Fibromyalgia Impact Questionnaires, FACIT and Hospital Depression and Anxiety Scale. The results indicated that individuals with FM had lower experimental pain reporting variability, that is, they were more reliable in assessing pain than individuals in the control group. In the patient group, the better the performance in the memory task, the lower the variability. These results suggest that the experience of clinical pain may improve the pain reporting reliability and that memory skills may be essential for pain reporting ability. A better understanding of the cognitive mechanisms involved in the variability of pain reporting may have implications for improving the evaluation of this experience and thus contribute to improvements in diagnosis and treatment of pain.
Description
Keywords
Avaliação da dor Variabilidade da dor FM FAST (Focused Analgesia Selection Test) Memória Pain assessment Pain variability Memory