Jenna M. Morogiello, Nicholas G. Murray, Tamerah N. Hunt, Brandonn S. Harris, Brian J. Szekely, George W. Shaver

Morogiello et al., J Clin Transl Res 2018; 4(2): 3

Published online: August 1, 2018


Background and Aim: Executive functions are high-level cognitive processes that allow a person to successfully engage in an independent and self-fulfilling life. Previous literature indicates that chronic pain can affect executive function, but there are limited studies that investigate the effect of acute pain on executive function. The purpose of this study was to determine if acute pain affects executive function in recreationally active individuals who sustained a musculoskeletal injury. 

Methods: Twenty-four recreationally active participants who presented with acute pain following a musculoskeletal injury underwent a neuropsychological battery within 72 hours of injury. Follow up testing occurred within two weeks from the initial testing session when participants were pain free. Pain intensity was measured using the Visual Analog Scale (VAS). The neuropsychological battery consisted of the following tests: Digit Span (DS), Rey Auditory Verbal Learning Test (RAVLT), and Trail Making Test B (TMT-B). The DS was broken into two separate scores, the RAVLT four scores, and TMT-B one score. Seven paired samples t-tests were conducted using an adjusted alpha level of 0.007. 

Results: Participants had significantly improved scores when pain free in DS forwards (p<0.007) and TMT-B (p<0.007). No significant difference was observed for the DS backward (p=0.023), RAVLT A1 (p=0.563), RAVLT sum A1 to A5 (p=0.953), RAVLT A6 (p=1.0), RAVLT recognition list A (p=0.009). These results suggest that immediate recall and complex attention may be diminished in individuals who experience acute pain due to a musculoskeletal injury. 

Conclusions: Results from this study suggest acute pain from musculoskeletal injuries may disrupt executive function. 

Relevance for patients: Patients should be aware that there may be cognitive changes after a musculoskeletal injury. Knowing which cognitive domains may be impaired during acute pain could impact clinical practice and further benefit patients suffering from pain and its associated symptoms.


Author affiliation

1 Waters College of Health Professions, Department of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia, United States
2 School of Community Health Sciences, University of Nevada, Reno, Nevada, United States

*Corresponding author: 

Jenna M. Morogiello

Campus Recreation and Intramurals, Georgia Southern University, P.O. Box 8078, Statesboro GA 30460-8076, United States

Tel: +1 912 478 5436 


Handling editor:

Michal Heger
Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands


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