Pain Neuroscience Education and Memory

Official title

Pain Neuroscience Education's Effect on Memory and Pain Drawings: An Exploratory Study

Overview

Brief Summary: The goal of this observational study (case series) is to determine whether Pain Neuroscience Education (PNE) can influence memory function and sensory awareness in adults (18 years and older) experiencing chronic pain lasting more than one year. The main questions it aims to answer are: Does a single PNE session improve memory performance, as measured by the Montreal Cognitive Assessment (MoCA)? Does PNE change sensory awareness, as represented by alterations in body pain drawings using a grid overlay method? Participants will: Complete pre-intervention assessments, including: Numeric Pain Rating Scale (NPRS) Body chart drawing to map pain area Montreal Cognitive Assessment (MoCA) Pain Catastrophization Scale (PCS) Receive a 10-15 minute standardized PNE session delivered by a licensed clinician trained in pain science Complete the same assessments immediately after the intervention to identify any changes in memory, sensory awareness, and pain perception This study aims to explore whether PNE can positively impact cognitive and sensory functions affected by chronic pain, beyond its already-established effects on movement and pain intensity.

Detailed description

Detailed Description:

Chronic pain is a complex, multidimensional condition affecting approximately 25% of the global population. It is increasingly understood through the lens of brain-based changes, particularly the dynamic pain connectome, a network of brain regions involved in sensory, cognitive, and emotional processing. Functional reorganization in chronic pain patients may contribute to clinical symptoms beyond pain, such as memory loss, decreased sensory awareness, and altered motor control.

Pain Neuroscience Education (PNE) is an educational intervention that aims to reconceptualize a patient's understanding of pain to reduce fear-avoidance, pain catastrophization, and disability. Systematic reviews have demonstrated its effectiveness in reducing pain and improving movement. Early fMRI studies suggest that PNE may also deactivate pain-related brain areas and normalize brain function.

This case series seeks to explore the impact of a single PNE session on cognitive (memory) and sensory (body perception) outcomes in individuals with chronic pain. Participants (aged 18 and older) who meet inclusion criteria and consent to the study will undergo pre- and post-intervention assessments. These include:

Numeric Pain Rating Scale (NPRS)

Pain body chart (grid overlay method)

Montreal Cognitive Assessment (MoCA)

Pain Catastrophization Scale (PCS)

Following baseline assessments, participants will receive a 10-15 minute individualized PNE session delivered by licensed clinicians trained in advanced pain science. Immediately post-intervention, assessments will be repeated to evaluate changes.

The study aims to contribute to the understanding of how PNE may influence brain-related symptoms associated with chronic pain, specifically memory function and sensory mapping. Findings could provide early evidence to support broader applications of PNE beyond movement-related outcomes.

Interventions

• Behavioral Pain Neuroscience Education (PNE)
  A 10-15 minute individualized educational session focusing on the neuroscience of pain. The session aims to reconceptualize the patient's understanding of their chronic pain by explaining the underlying biological, cognitive, and emotional mechanisms involved. Clinicians use a standardized checklist of metaphors and teaching tools tailored to the patient's clinical presentation.

Primary outcome measures

• Memory Function (Montreal Cognitive Assessment - MoCA) [Time frame: At baseline (prior to the pain neuroscience education session) and immediately after completion of the treatment session]
• Sensory Awareness (Body Chart Pain Area - Grid Overlay Count) [Time frame: At baseline (prior to the pain neuroscience education session) and immediately after completion of the treatment session]

Secondary outcome measures (2)

• Self-Reported Pain Intensity (Numeric Pain Rating Scale - NPRS) [Time frame: At baseline (prior to the pain neuroscience education session) and immediately after completion of the treatment session]
• Pain Catastrophization (Pain Catastrophization Scale - PCS) [Time frame: At baseline (prior to the pain neuroscience education session) and immediately after completion of the treatment session]

Eligibility criteria

Inclusion criteria

• Age 18 and above
• Chronic pain > 1 year
• Provide written consent
• Proficient in reading and understanding English

Exclusion criteria

• Not willing to participate in the study
• Have received PNE as a treatment before

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Publications

• Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment
• Lansdall CJ, McDougall F, Butler LM, Delmar P, Pross N, Qin S, McLeod L, Zhou X, Kerchner GA, Doody RS. Establishing Clinically Meaningful Change on Outcome Assessments Frequently Used in Trials of Mild Cognitive Impairment Due to Alzheimer's Disease. J Prev Alzheimers Dis. 2023;10(1):9-18. doi: 10.14283/jpad.2022.102. PMID 36641605
• Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. PMID 15817019
• Sanders NW, Mann NH 3rd, Spengler DM. Pain drawing scoring is not improved by inclusion of patient-reported pain sensation. Spine (Phila Pa 1976). 2006 Nov 1;31(23):2735-41; discussion 2742-3. doi: 10.1097/01.brs.0000244674.99258.f9. PMID 17077744
• Lacey RJ, Lewis M, Jordan K, Jinks C, Sim J. Interrater reliability of scoring of pain drawings in a self-report health survey. Spine (Phila Pa 1976). 2005 Aug 15;30(16):E455-8. doi: 10.1097/01.brs.0000174274.38485.ee. PMID 16103839
• Matthews M, Rathleff MS, Vicenzino B, Boudreau SA. Capturing patient-reported area of knee pain: a concurrent validity study using digital technology in patients with patellofemoral pain. PeerJ. 2018 Mar 8;6:e4406. doi: 10.7717/peerj.4406. eCollection 2018. PMID 29568700
• Wand BM, Keeves J, Bourgoin C, George PJ, Smith AJ, O'Connell NE, Moseley GL. Mislocalization of sensory information in people with chronic low back pain: a preliminary investigation. Clin J Pain. 2013 Aug;29(8):737-43. doi: 10.1097/AJP.0b013e318274b320. PMID 23835768
• Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov;94(2):149-158. doi: 10.1016/S0304-3959(01)00349-9. PMID 11690728

Identifiers

NCT: NCT07252596 · PNEMEMORY202510

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗