The role of executive functions in task-related analgesia

Introduction: Recent research suggests that weaker executive functions may
be linked to a higher risk of pain chronicity. However, little is known about
how executive functions affect the modulation of acute pain. The present
study aimed to investigate the impact of inhibitory control on the success of
cognitive distraction from pain. Methods: Participants completed a battery
of cognitive tasks (Go/NoGo, Color Stroop, Eriksen Flanker), assessing their
cognitive inhibition and selective attention abilities. Additionally, self-report
measures of pain catastrophizing and fear of pain were administered. In a pain
distraction paradigm, participants completed either a cognitively demanding
working memory task (2-back task) or a visually matched easy control task
(target response task) while receiving warm or painful thermal stimuli to their
left forearm. Nociceptive stimulus intensity was individually calibrated for
each participant. Moreover, to maintain a similar level of task difficulty
across participants, task speed was continuously adapted based on the
participant's performance in the previous trials. Following each trial,
participants rated the perceived intensity and unpleasantness of the thermal
stimuli on visual analogue scales. Results: As expected, preliminary results
indicate that the 2-back task, but not the target response task, successfully
distracted participants from thermal pain, manifesting in significantly lower
intensity and unpleasantness ratings. Importantly, the magnitude of the
distraction effect was negatively associated with the Flanker effect.
Discussion: In line with previous research, engaging in a cognitively
demanding task led to significantly lower pain intensity and unpleasantness
ratings when compared to an easy control task. Moreover, results indicate that
better interference control abilities may predict greater task-related analgesia.
Taken together, the results of the present study suggest that it is crucial to
assess executive functions to develop a better understanding of the
mechanisms behind cognitive distraction from pain.