B - 94 Chronic Pain Is Associated with Greater Cognitive Variability on Neuropsychological Assessments

Objective To examine performance variability on a brief neuropsychological assessment battery associated with self-reported pain symptoms. Methods 461 patients who were referred for a presurgical psychological evaluation as dorsal column spinal stimulator candidates (61.2% female, 86.7% white, M(age) = 53.25, SD = 13.57, M(education) = 13.10, SD = 2.66). Measures included Trail Making Tests A and B, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Wechsler Abbreviated Scale of Intelligence (WASI), Pain Catastrophizing Scale (PCS), and Pain Disability Index (PDI). Intra-individual variability (IIV) was calculated as the standard deviation around each individual’s overall test battery mean (OTBM) for cognitive tests. Coefficient of variation (CoV) was calculated as IIV/OTBM. Results CoV was significantly correlated with PCS (r = 0.21, p < 0.001) and PDI (r = 0.18, p < 0.001) total scores. CoV was positively correlated with PDI subscales: family/home responsibilities (r = 0.15, p = 0.002), recreation (r = 0.13, p = 0.005), social activity (r = 0.13, p = 0.005), self-care as it pertains to independent daily living and personal maintenance (r = 0.23, p < 0.001), and self-care as it pertains to life supporting behaviors (r = 0.21, p < 0.001) but occupation and sexual behavior were not significantly related to CoV. CoV was significantly correlated with highest pain rating (r = 0.15, p = 0.001), lowest pain rating (r = 0.19, p < 0.001), and current pain rating at the time of testing (r = 0.11, p = 0.023). Conclusions This is the first study to demonstrate that chronic pain was associated with greater cognitive variability. This may explain some perceived cognitive deficits in chronic pain patients.