B-153: Neurocognitive and Emotional Profiles Across Pain Phenotypes: A Focused Literature Review

Abstract

Objective: Chronic pain is a multidimensional condition affecting cognitive, emotional, and functional domains. Although medical and rehabilitation disciplines differentiate pain by underlying mechanisms (nociceptive, neuropathic, nociplastic), neuropsychological research often treats chronic pain as a unitary construct. This focused literature review examined whether distinct neurocognitive and emotional profiles are associated with different pain phenotypes in adults. Method/Data Selection: A targeted literature search was conducted using electronic databases (PubMed, PsycINFO, CINAHL) to identify peer-reviewed studies involving adults with nociceptive, neuropathic, or nociplastic pain. Studies were included when pain was a primary feature and could be classified using established mechanistic frameworks (e.g., fibromyalgia, complex regional pain syndrome). Seven studies met inclusion criteria. Data extraction focused on pain classification, sample characteristics, and neurocognitive and emotional outcomes. Results/Data Synthesis: Findings suggest meaningful differences across pain phenotypes. Nociceptive pain was associated with inefficiencies in encoding and reduced verbal memory performance. Neuropathic pain demonstrated heterogeneous cognitive findings, with some studies showing preserved attention and others indicating deficits in memory, executive functioning, and cognitive flexibility, particularly in older samples. Nociplastic pain showed more consistent associations with reduced working memory and executive dysfunction, alongside elevated affective symptoms and fatigue. Direct comparisons between pain types were limited. Conclusions: These findings highlight limitations of unitary models of chronic pain in neuropsychology. Mechanistic differentiation may enhance assessment, case conceptualization, and intervention planning. However, interpretation must account for comorbid mood symptoms, fatigue, and medical factors. Further research using standardized pain phenotyping and domain-specific cognitive assessment is needed to clarify these relationships and support interdisciplinary integration.