Evidence map›Paper›PMID 42089183›Full record

ArticleEuropean journal of pain (London, England)2026

Sustained Attention Instability as a Cognitive Biomarker in Chronic Spine Pain: A 90-second Visual Attention Test.

Kai-Uwe Lewandrowski, Kenneth Blum, Morgan Lorio, Colin Hanna, Alexander P L Lewandrowski, Thomas Lundquist, Rossano Kepler Alvim Fiorelli, Guilherme J Schmidt, Emmanouil Liodakis, Mark Gold and 5 more

Abstract read
In one paragraph

Article in European journal of pain (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Kai-Uwe LewandrowskiDepartment of Orthopedics, Hospital Universitário Gaffree Guinle Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Kenneth BlumDivision of Personalized Genomics, The Blum Institute of Neurogenetics & Behavior, Austin, Texas, USA.
Morgan LorioOrlando College of Osteopathic Medicine, Winter Garden, Florida, USA.
Colin HannaBehavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, New York, USA.
Alexander P L LewandrowskiDepartment of Biological Sciences, Dornsife College of Letters, Arts & Sciences, University of Southern California, Los Angeles, California, USA.
Thomas LundquistBrigham Young University, Provo, Utah, USA.
Rossano Kepler Alvim FiorelliNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Guilherme J SchmidtNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Emmanouil LiodakisKlinik für Unfall-, Hand- Und Wiederherstellungschirurgie, Homburg, Germany.
Mark GoldCenter for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, California, USA.
Juliana J SchmidtNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Eelco Van DuinkerkenNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Carolina AbramoviczNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Andreza P MaiaNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.
Sergio Luis SchmidtNeurology Post-Graduate Program, Hospital Universitário Gaffree Guinle, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil.ORCID https://orcid.org/0000-0001-7654-5507

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic spine pain is linked to self-reported cognitive complaints. However, objective markers are lacking. The 90-s Continuous Visual Attention Test (CVAT) quantifies key attention subdomains: reaction time (RT, alertness), RT variability (VRT, sustained attention), omission errors (focused attention) and commission errors (impulsivity).

objectiveThis study aimed to identify which specific attentional subdomains, measured by the CVAT, are impaired in adults with chronic spine pain.

methodsThis prospective case-control study included 84 adults with chronic lumbar/cervical pain (≥ 3 months) and 118 healthy controls. A MANCOVA tested group differences on CVAT variables, controlling for age and sex, followed by Bonferroni-corrected ANCOVAs. To isolate cognitive variability from general processing speed, the coefficient of variability (VRT/RT) was also analysed. Logistic regression assessed the predictive power of CVAT indices for pain status.

resultsThe MANCOVA showed a significant group effect (Pillai's Trace = 0.46, F(4,195) = 41.43, p < 0.001). Patients exhibited impairments in all measures p < 0.001 (η

conclusionsPatients with chronic spine pain demonstrate attentional deficits, with sustained attention instability (VRT and VRT/RT) as the most robust marker. The CVAT detects this impairment, offering a practical tool for clinical assessment to inform treatment and monitor cognitive function in pain management. LEVEL OF EVIDENCE: III (prospective case-control). SIGNIFICANCE STATEMENT: A brief, 90-s computerized attention test provides an objective, clinic-ready screen for sustained-attention instability in spine pain patients. Identifying cognitive vulnerability at the point of care can inform perioperative counselling, driving/work-safety guidance and rehabilitation planning, and it may help monitor treatment response alongside pain metrics, offering a noninvasive, nonpharmacologic complement to standard pain assessment.

Indexed as

AttentionBack PainChronic PainCognitionAdultCase-Control StudiesFemaleHumansMaleMiddle AgedNeuropsychological TestsProcessing SpeedProspective StudiesReaction Timeattentioncognitive dysfunctionexecutive functionlow back painneck painneuropsychological testspain measurementpsychomotor performancereaction timespinal diseases

Identifiers

PMID42089183
PMCPMC13147231

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.