Pain and mild traumatic brain injury: the implications of pain severity on emotional and cognitive functioning

Brain Inj. 2013;27(10):1134-40. doi: 10.3109/02699052.2013.804196. Epub 2013 Jul 29.


Primary objective: The aim of this study was to examine the effect of high chronic pain on (a) neuropsychological test performance and (b) self-reported emotional complaints in persons suffering from Postconcussional Disorders (PCD) after a mild traumatic brain injury (TBI).

Research design: A two-group comparative research design was employed.

Methods and procedure: An outpatient sample of 66 patients with mild TBI and PCD using the Ruff Neurobehavioural Inventory (RNBI) and a neuropsychological test battery.

Main outcomes and results: According to ANOVAs, no significant between-group differences were found on neuropsychological test performances; however, the high pain group had significantly more emotional residuals; particularly elevated on the RNBI were the Anger and Aggression, Anxiety, Depression and Paranoia and Suspicion sub-scales. Furthermore, an ANOVA found participants of the high pain group reporting significantly higher impairments on the RNBI Cognitive, Physical and Quality-of-Life composite scores and several RNBI sub-scales compared to their pre-morbid functioning.

Conclusions: High chronic pain exacerbates the emotional aspect of PCD and, therefore, should be given special observance in treatment settings.

Publication types

  • Review

MeSH terms

  • Adult
  • Analysis of Variance
  • Brain Injuries / epidemiology
  • Brain Injuries / physiopathology
  • Brain Injuries / psychology*
  • Chronic Pain / epidemiology
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology*
  • Cognition Disorders / epidemiology
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology*
  • Emotions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Post-Concussion Syndrome / epidemiology
  • Post-Concussion Syndrome / physiopathology
  • Post-Concussion Syndrome / psychology*
  • San Francisco / epidemiology
  • Self Report
  • Severity of Illness Index