Impact of Pain on Cognitive Function in Forensic Neuropsychology Context

Chronic pain is a biopsychosocial condition with a complex neuroscientific and neuropsychological literature. Common types of pain that are seen in the medicolegal context include headaches and musculoskeletal and neuropathic pain, all of which are known to affect neuropsychological test results. Differentiating between the cognitive impact of pain and the effects of traumatic brain injury and other factors, such as emotional distress or fatigue, is often challenging, especially in forensic determinations. Cutting through the polarization of forensic examiners’ opinions on the significance and nature of chronic pain impact on neuropsychological function with research evidence can make neuropsychological assessments more objective and defensible in court. This review focuses on surveying and integrating the available vast empirical evidence from neuroscience and neuropsychology regarding the cognitive impact of chronic pain. Our critical review will emphasize the implications of the new evidence for the forensic assessment determinations regarding causality, diagnosis, impact on function, and prognosis and treatment. To this end, electronic search engines, including PubMed, PsycINFO, and Google Scholar (up to January 2018), have been screened and reviewed both for the neuroscience and neuropsychological literature related to chronic pain, and subsequently updated for content and referencing.